Analysis of the Frontal Sinus Morphology and the Titanium Plates Shape in Skull Fracture for Human Identification

Abstract

Human identification can be performed by several methods, as anatomical structures of the facial skeletal and individuals signals. The aim of this study was to report a case of human identification from the morphological evaluation of the frontal sinus and the presence of titanium plates in skull after examination of Postero Anterior (PA) radiographs ante and postmortem. In 2008 a skull was found on a highway. Later, an alleged victim was found , who disappeared in late 2007. The skull showed postmortem teeth lost, presence of round hole in the right supra-orbital region, consistent with lesion caused by gunshot. It was also noted the presence of a miniplate of bone fixation in the form of inverted "T" in several locations of the nasal bones and bone remodeling signals in the face. PA radiograph of the skull was performed for the purpose of comparison with the X-rays provided by antemortem family. By overlapping radiographic images, there was similarity between the characteristics presented by the skull and found the alleged victim, as the frontal sinus, shape and height of the orbits, and miniplate fixation of bone with the same shape and size, not leaving no doubt that the radiographs belong to the same individual.

Cuerpo esqueletizado identificado por análisis morfológico del seno frontal y características del material de osteosíntesis - relato de caso pericial

“…In this case, the morphological similarity between AM and PM x-ray images of the frontal sinus, comparative procedure widely supported and described in the literature (7-9,16.17) , made the positive identification of the victim possible, paving the way for the criminal investigation to arrest and prosecute those involved in his death. The presence of the osteosynthesis plate on the lateral wall of the right orbit was an additional element for comparison, with results consistent with those of the frontal sinus (9) . Finally, it should be mentioned that this method is faster and less expensive than a DNA test, showing how important it is to have a radiology service in the IMLs or, if this were not possible, to enter into agreements with public or private radiological laboratories.…”

“…These should be used with caution to avoid misleading or inconsistent conclusions. In return, they become valuable in a morphologic, qualitative and quantitative assessment of the frontal sinus, bearing in mind that this expansive cavity is unique and does not change in adults (7)(8)(9)16,17) . In this case, the morphological similarity between AM and PM x-ray images of the frontal sinus, comparative procedure widely supported and described in the literature (7-9,16.17) , made the positive identification of the victim possible, paving the way for the criminal investigation to arrest and prosecute those involved in his death.…”

“…Radiograph images are widely used for identification purposes, especially when a lophoscopy analysis cannot be performed, and are very useful in cases of charred, decaying and skeletonized bodies (4,5,9,14) . This is further enhanced by the number of skull x-rays performed on a daily basis, as the population has increased access to dental care, to diagnose, plan and/or check different clinical treatments (5,15).…”

“…In fact, PA radiographs make it possible to study the anatomical features (dental or bone), pathological and/or therapeutic characteristics, as well as the type of a possible osteosynthesis material (9) . However, we should remember that PA radiographs are not the best alternative for a detailed dental analysis, if compared to panoramic (5) or intraoral (1) radiographs.…”

“…Among the many methods available it is worth mentioning those comparing AM and PM radiographic imaging of the skull (4) , as the morphological variability of its many anatomical structures, like the frontal sinus, is very useful in forensics to determine a person's identity (7) . The specialized literature presents cases, although few, where human remains were identified by analyzing the frontal sinus (7,8) , comparing images of the anatomical characteristics of the sinus and those of the osteosynthesis material (9) . The aim of this study is to present a forensic case report of a skeletonized body identified by analysis of frontal sinus morphology and the type and location of the material used to reduce trauma-induced fractures.…”