Skull Radiographs Research Articles

Estimating infant age from skull X-ray images using deep learning

This study constructed deep learning models using plain skull radiograph images to predict the accurate postnatal age of infants under 12 months. Utilizing the results of the trained deep learning models, it aimed to evaluate the feasibility of employing major changes visible in skull X-ray images for assessing postnatal cranial development through gradient-weighted class activation mapping. We developed DenseNet-121 and EfficientNet-v2-M convolutional neural network models to analyze 4933 skull X-ray images collected from 1343 infants. Notably, allowing for a ± 1 month error margin, DenseNet-121 reached a maximum corrected accuracy of 79.4% for anteroposterior (AP) views (average: 78.0 ± 1.5%) and 84.2% for lateral views (average: 81.1 ± 2.9%). EfficientNet-v2-M reached a maximum corrected accuracy 79.1% for AP views (average: 77.0 ± 2.3%) and 87.3% for lateral views (average: 85.1 ± 2.5%). Saliency maps identified critical discriminative areas in skull radiographs, including the coronal, sagittal, and metopic sutures in AP skull X-ray images, and the lambdoid suture and cortical bone density in lateral images, marking them as indicators for evaluating cranial development. These findings highlight the precision of deep learning in estimating infant age through non-invasive methods, offering the progress for clinical diagnostics and developmental assessment tools.

Imaging of the Pediatric Cranial Sutures in Abusive Head Trauma

Pediatric skull fractures are frequently encountered in accidental and abusive head trauma and often involve cranial sutures. However, skull fracture association with cranial sutural widening, crossing, or contacting ≥2 cranial sutures can be seen more commonly with abusive head trauma. Knowledge of cranial sutures and associated variants is helpful for an accurate diagnosis. 3D head CT is a significant aid in the identification of skull fractures contacting and crossing cranial sutures. Growing literature supports the elimination of concurrent skull radiographs (often performed as required components of follow-up skeletal surveys). Ultrashort TE/zero TE MRI is an emerging new imaging technique to consider for assessing skull fractures to aid in evaluating pediatric abusive head trauma.Learning Objective: To review skull fracture findings in abusive head trauma with attention paid to the cranial sutures (widening, crossing, or contacting ≥2 sutures). <list list-type="order"> <list-item>To recognize normal cranial sutural variants.</list-item> <list-item>To understand the role of CT versus radiographs in assessing skull fractures.</list-item> <list-item>To discuss ultrashort TE/zero TE MRI as an emerging technique for imaging skull fractures in abusive head trauma.</list-item> </list>

Auto-evaluation of skull radiograph accuracy using unsupervised anomaly detection.

Radiography plays an important role in medical care, and accurate positioning is essential for providing optimal quality images. Radiographs with insufficient diagnostic value are rejected, and retakes are required. However, determining the suitability of retaking radiographs is a qualitative evaluation. To evaluate skull radiograph accuracy automatically using an unsupervised learning-based autoencoder (AE) and a variational autoencoder (VAE). In this study, we eliminated visual qualitative evaluation and used unsupervised learning to identify skull radiography retakes from the quantitative evaluation. Five skull phantoms were imaged on radiographs, and 1,680 images were acquired. These images correspond to two categories: normal images captured at appropriate positions and images captured at inappropriate positions. This study verified the discriminatory ability of skull radiographs using anomaly detection methods. The areas under the curves for AE and VAE were 0.7060 and 0.6707, respectively, in receiver operating characteristic analysis. Our proposed method showed a higher discrimination ability than those of previous studies which had an accuracy of 52%. Our findings suggest that the proposed method has high classification accuracy in determining the suitability of retaking skull radiographs. Automation of optimal image consideration, whether or not to retake radiographs, contributes to improving operational efficiency in busy X-ray imaging operations.

Imaging diagnosis: Disseminated hemangiosarcoma in a Welsh pony.

A 16-year-old pony gelding presented with epistaxis and a head tilt. Referral skull radiographs suggested an ethmoid hematoma. Concurrent neurologic abnormalities prompted contrast-enhanced CT of the head and cranial neck, revealing numerous hyperattenuating masses throughout the brain and paranasal sinuses, along with a large osteolytic mass in the second cervical vertebra. The vertebral mass extended into the vertebral canal, causing focal extradural compressive myelopathy. These findings were inconsistent with ethmoid hematoma and metastatic hemangiosarcoma or malignant melanoma were prioritized as potential causes for the clinical signs. Postmortem examination confirmed the sinonasal, intracranial, and vertebral masses as hemangiosarcoma, and additionally revealed innumerable thoracoabdominal metastatic lesions and hemorrhagic foci. A final diagnosis of disseminated hemangiosarcoma was made. In this study, CT proved invaluable for evaluating the severity and characterizing regional disease and neural involvement, directly affecting case management decisions.

Dimensional changes of airways observed in lateral radiographs of patients undergoing orthognathic surgery at the carlos Ardila Lulle clinic from 2010 to 2016

Introduction: Skeletal alterations are variations that occur in the jaws and occlusion. In addition, these can generate problems in the pharyngeal airways. For this reason, different procedures arise to correct bony problems, such as orthognathic surgery. However, these surgical techniques do not fully prove significant changes in the upper and lower pharyngeal airways. Objectives: To determine the anteroposterior dimensional changes of the upper and lower pharyngeal airways in lateral skull radiographs of patients undergoing orthognathic surgery. Methodology: A descriptive observational study was carried out. Cross-sectional. The sample included 24 lateral cephalic radiographs of patients between 18 and 60 years of age who underwent orthognathic surgery. Proportions were calculated for qualitative variables and measures of central tendency and dispersion for quantitative variables. For cephalometric variables before versus after; the paired Student's t-test or the Wilcoxon sign test was applied according to the distribution of the data, additionally the Pearson correlation coefficient was applied to relate the dimensional changes of the pharyngeal airways with the SNA and SNB planes. A significance level of α ≤ 0.05 was considered for the analysis. Results: It is important to highlight that for maxillary retrocession surgery there were statistically significant differences before and after the surgical process (p=0.0023) since thanks to this surgery the patients had 1.7 mm more in their upper pharyngeal space. While the forward and also the mandibular backward surgeries allowed them to gain 1.5 (p=0.0108) and 1.8 mm (p=0.0184) in this same pharyngeal space. Conclusion: Twenty-four lateral skull radiographs were evaluated, in which it was possible to determine changes in the amplitude of the upper and lower pharyngeal airways, which could have been produced by the set of surgical procedures to which each of the patients underwent.

Use of a wax bite for accurate lateral skull radiographs

CPD/Clinical Relevance: The reader will learn a method of simplifying the process of taking a lateral skull radiograph with the mandible in a reproducible position in patients who have a variable jaw closure position.

Comparison study of chewing efficiency in patients with different vertical skeletal patterns of Angle Class I and Angle Class II malocclusions.

The purpose of this study was to analyze and compare the differences in chewing efficiency among patients with different vertical skeletal types of Angle Class I and Angle Class II malocclusions, to provide reference for orthodontic clinical practice. Sample size estimation revealed a minimum of 53 for each class. Thus, a total of 108 patients with Angle Class I and Angle Class II malocclusions were selected. Lateral skull radiographs were taken, and head measurements were analyzed via geometric tracing software. Chewing efficiency was measured using the gravimetric method to compare between the two groups. The vertical skeletal pattern was classified via Steiner analysis. Significant statistical differences in chewing efficiency were observed between patients presenting with Angle Class I and Angle Class II malocclusions (P < .05). Additionally, significant differences in chewing efficiency were observed among patients with different vertical skeletal patterns (P < .05). Furthermore, a statistically significant difference in chewing efficiency was found between men and women (P < .05). Patients with Angle Class I malocclusions exhibited significantly higher chewing efficiency compared to those with Angle Class II malocclusions. Among patients with different vertical facial types, the chewing efficiency followed the order of low angle > normal angle > high angle. Moreover, men demonstrated a higher chewing efficiency than women.

Clinical, Radiographic and Rhinoscopic Features of Primary Intra-Nasal Transmissible Venereal Tumour in Four Dogs and its Treatment

Transmissible venereal tumours are contagious tumours that typically affects intact male and female canines. Four dogs were presented to Small Animal Out-Patient unit of Madras Veterinary College Teaching Hospital, Chennai with history of chronic unilateral epistaxis and sneezing. Leukocytosis with neutrophilia was a consistent finding in all dogs whereas the serum biochemical values where unremarkable. Lateral and dorsoventral radiograph of skull revealed space occupying lesion suggesting soft tissue mass in the nasal cavity. Rhinoscopy confirmed the presence of tumour mass occluding nasal passage. Nasal cytology revealed the presence of characteristic transmissible venereal tumour cells. Chemotherapy was initiated with Vincristine sulphate at the dose rate of 0.7 mg/m2. All the four dogs showed complete clinical recovery after four weekly doses of vincristine chemotherapy. Radiography repeated after four weeks confirmed the absence of space occupying mass in nasal cavity. The present study describes the clinical and diagnostic imaging changes in dogs with intra-nasal transmissible venereal tumour and its therapeutic management.

Analysis of Craniocervical Abnormalities in Osteogenesis Imperfecta during Growth

Osteogenesis Imperfecta (OI) is a genetic disease characterized by osteopenia and bone fragility in which the craniocervical junction is also affected. This is of special relevance due to the high prevalence in anomalies described in the literature as follows: basilar invagination, basilar impression, and platybasia. Methods. We analyzed 19 lateral skull radiographs and 14 magnetic resonance images (MRIs) of 28 patients with OI in which eight linear and five angular measurements were plotted to determine the existence of craniocervical junction anomalies and compare them with 38 lateral skull radiographs and 28 MRIs performed on age-matched healthy controls. Results. From the reference values obtained from the control sample for each age group, we established the limit value at which pathology could be suspected. Some of the variables studied showed a clear trend associated with growth. More than half of the patients (60.71%) presented an anomaly in the skull base. Conclusions. According to the diagnostic criteria used and taking +2.5 SD as the limit value, 10.71% of the patients had basilar invagination, 35.71% had basilar impression, and 39.29% had platybasia, the latter being the most common finding.

Rocabado-penning skull-cervical posture in orthodontic patients

The standing balance of the skull on the spine in its cervical portion is a factor of consideration for the diagnosis of cranio-mandibular disorders and alterations in patients of all ages without distinction, that is, it is essential to conceive an accurate diagnosis in children and adults. However, over time, this element had not been taken into account in the differential diagnosis protocol, despite the fact that biomechanical alterations and dysfunctions in both hard and soft tissues are evidenced in a lateral skull teleradiography, essentially requested to initiate treatment. To describe the cranio-cervical posture with the Rocabado-Penning analysis, in patients who come for consultation at the Instituto Latinoamericano de Estudios Superiores (ILES). The study was a cross-sectional descriptive observational study. The anatomical-radiological study was carried out on selected patients from 2012 to 2019 who attended a private institute to undergo orthodontic treatment. Lateral skull radiographs were included where the 7 cervical vertebrae were observed. The sample was made up of 30 patients. 66.7% were female, 96.7% were brachyfacial type, 63.4% had Ricketts skeletal Class I, 63.4% had deep bites, the position of the hyoid bone was low for 63. .4% and the depth of the cervical spine is rectified by 96.7%. No statistically significant relationship was found between skeletal classes and suboccipital distances. In the patients in the sample, class I prevailed, brachyfacial, deep bite, low hyoid bone and rectified cervical spine, the latter could result in pain, tinnitus or other symptoms if not treated in time.

Evaluation of Zepp’s Procedure in Management of Chronic Otitis Externa in Dogs

The study was conducted on 10 dogs presented at VCC, VSR, CVAS Bikaner with the owner complaint of consistent shaking of head and scratching of ear, rubbing of ear to hard object, purulent foul smelling discharge from ear and also had history of long medicinal treatment using NSAIDS, steroids and antibiotics. Clinical otoscopic examination of the ears revealed purulent odoriferous discharge, with stenosis and calcification of lateral ear canal in some cases. For definitive diagnosis ear exudate was collected in sterile swabs inserted in lateral ear canal using otoscope, and it was evaluated for parasites, bacteria, fungi, yeast. Skull radiography was performed to evaluate calcification in the ear canal and involvement of middle ear. After thorough examination it was concluded that the animals were suffered from chronic otitis externa and decided to perform zepps procedure (lateral ear canal resection) to increase drainage, facilitate ventilation of ear canal and easy placement of topical agents into horizontal ear canal. Zepp’s procedure was performed under general anaesthesia; post-operative care was done using regular application of topical steroids, nonsteroidal anti-inflammatory drugs and antibiotics along with systemic antibiotics. After one month of post-operative care four ear showed excellent healing and dryness of the ear, Infection subsided in three ears and no improvement was seen in three ears. Microbiology suggested mixed bacterial infection in 6 dogs. Zepp’s procedure is a conservative surgical operation found to be a choice of surgical management in cases of early stages of otitis externa which has not been progressed to otitis media.

Two-Dimensional Geometric Morphometric Method on Frontal Sinus for Race Estimation: A Lateral Skull Radiograph Study

Introduction: Race estimation of unknown individual is essential in forensic investigation. The resiliency of frontal sinus makes it a potential tool for biological profiling, particularly in cases where fragmented skeleton persists. Geometric morphometrics is an efficient way to characterise shape. However, the use of frontal sinus to identify race of Malaysians is yet to be investigated. This research employed a two-dimensional (2D) geometric morphometric to examine the morphological differences of the frontal sinus among the major races in Malaysia. Methods: Lateral skull radiographs which comprising of 453 adult Malaysian (151 Malays, Chinese and Indian respectively) were used. The 2D landmarks of eight were placed on the digitalized radiographs and 2D geometric morphometric analysis was performed using MorphoJ software. Results: Procrustes ANOVA revealed a significantly different frontal sinus shape (p-value &lt; 0.05) between races. Canonical variate analysis showed significantly different frontal sinus morphology (p-value &lt; 0.05) between Malay and Indian as well as Chinese and Indian. Discriminant function analysis with cross-validation demonstrated a 57.4% accuracy rate. Conclusion: This population-specific study based on frontal sinus of Malaysians using the 2D geometric morphometric, though less reliable, sheds new light on the potential applicability of this method for race estimation purpose.

Lifetime attributable risks (LARs) of cancer in the fetus associated with maternal radiography examinations

Purpose For various reasons, pregnant women are occasionally exposed to ionizing radiation during radiology examinations. In these situations, it is essential to determine the radiation dose to the fetus and any associated risks. The present study attempts to calculate the mean dose for the fetus to estimate the possible cancer induction and cancer mortality risks resulting from maternal radiography exams. Material and methods The GATE Monte Carlo platform and a standard voxelized pregnant phantom were employed to calculate fetal radiation dose during maternal radiography exams. The data published in Biological Effects of Ionizing Radiation VII were used to convert fetal dose to lifetime attributable risks (LARs) of cancer incidence and cancer-related mortality. Results The fetal doses and LARs of cancer incidence and cancer-related mortality for the radiographs of the chest and skull were negligible. The maximum LAR values for the lateral view of the abdomen in computed and digital radiography are 5598.29 and 2238.95 per 100,000 individuals, respectively. The computed radiography of the lateral view of the abdomen revealed the highest LAR of cancer-related mortality (2074.30 deaths for every 100,000 people). Conclusion The radiation dose incurred by the fetus due to chest and skull radiographs was minimal and unlikely to cause any abnormalities in the fetus. The discernible elevation in the lifetime attributable risk associated with cancer incidence and mortality arising from lateral computed radiography examinations of the abdomen warrants careful consideration within the realm of maternal radiography examinations.

CLINICAL FINDINGS OF DENTAL DISEASE AND POTENTIAL CONTRIBUTING FACTORS IN PYGMY SLOW LORISES (NYCTICEBUS PYGMAEUS) UNDER HUMAN CARE.

Dental disease is a common finding in pygmy slow lorises (Nycticebus pygmaeus) under human care, but the etiology is not fully understood. The small oral cavity in this species can make diagnosis of dental disease difficult. This retrospective study evaluated medical records and diet and husbandry protocols from 18 participating institutions with the objective of describing the signalment, clinical signs, physical exam findings, tooth type, tooth location, diagnostics used, and treatments performed to help guide care for dental disease. In addition, the study aimed to identify potential contributing factors to dental disease in this species. Of 59 animals with medical records evaluated, 42 (71.2%) had dental disease: 19 (44.2%) males, 20 (46.5%) females, and 3 (9.3%) without gender documented. Average age at onset of dental disease was 7.6 yr in males and 9 yr in females. Multiple lorises with dental disease (n = 12; 28.6%) had no premonitory clinical signs, and dental disease was found incidentally on examination. On dental examination, 30 lorises (71.4%) had evidence of gingivitis. In 13 cases skull radiographs were taken, but the majority of images (n = 8; 61.5%) were nondiagnostic for pathologic dental changes. A small proportion of cases with dental abnormalities (n = 4; 9.5%) were diagnosed using computed tomography. In total, 175 teeth were extracted from 31 patients; molars were the most frequently extracted tooth (n = 55; 31.4%). No substantial differences in diets were noted among many of the participating institutions, and not all slow lorises evaluated developed dental disease (n = 17; 28.8%). This retrospective study provides clinical findings on slow loris dental disease and guidance for the veterinary care and management of slow lorises under human care.

Nasal cavity cancer in rabbit

Exotic animal medicine is a dynamic part of veterinary medicine. It is very important to publish rare cases in order to share experience. Diseases in the sinuses and nasal cavities are common. Seemingly ordinary upper respiratory tract infections can have very different causes, i.e. foreign bodies, abscesses or neoplastic lesions. The latter are among the extremely rare ones. Their diagnosis is difficult due to the need for specialised examinations, i.e. tomography or rhinoscopy. The case described in this report concerns a rabbit in which extensive diagnostics were performed to determine the cause of chronic nasal discharge. Bacteriological cultures, CT scans and rhinoscopy were performed to remove the lesion. To determine its nature, a histopathological examination was also performed, which revealed the presence of a nasal carcinoma. A rabbit with a recurrent bilateral nasal discharge was brought to the clinic. It was initially diagnosed with bacterial rhinitis and treated with antibiotics. During the next 6 months, the discharge recurred and then became unilateral and whitecoloured. In a further diagnostic procedure, the rabbit had a skull radiograph, which excluded sinus infections and the presence of a foreign body in the nasal cavity. After the following 6 months, the rabbit appeared to have a louder than usual respiratory murmur and snoring during sleep. A radiograph showed a lesion in the nasal conchae. A rhinoscopy further revealed a mass within the right nasal cavity. The lesion was removed and submitted for histopathological examination, which confirmed nasal carcinoma. Radiation therapy was suggested, which the owners declined. After removal of the lesion, the nasal discharge decreased and did not contain any blood. Further treatment of the rabbit after the rhinoscopy consisted of nebulisation with a solution of budesonide and enrofloxacin 2 × 2 daily for 5 days, after which the condition began to stabilise. A follow-up clinical examination 3 months after the rhinoscopy revealed no recurrence of the clinical symptoms.

Treatment of depressed skull fractures with vacuum devices in the neonatal period: A case series.

The management of depressed skull fractures in infants can be either conservative or surgical. This study aimed to examine the outcomes of management with a negative-pressure vacuum device on depressed skull fractures in newborns. Twenty-eight patients (aged 1-6days) with simple depressed skull fractures underwent skull elevation using negative-pressure vacuum devices. A protocol for nonsurgical management was adopted for infants with such fractures between 2010 and 2023. All patients were initially evaluated with neurological examination and complementary assessments-hematological and coagulation studies, transfontanel transcranial ultrasound, skull radiography, and computed tomography scanning with three-dimensional reconstruction-according to availability and clinical needs. Gentle (negative) extraction pressure was applied with one of several devices (according to institutional availability) for a maximum duration of 60s; this was performed as soon as possible after diagnosis, preferably within 72h. Follow-up data, available in the clinical records, were reported. All patients exhibited satisfactory elevation of the depressed bone without associated injuries, except one patient who presented with an associated cephalohematoma which prevented optimal device coupling to generate sufficient vacuum pressure for correction. Neither neurological deficits nor development of epilepsy was noted; normal neurological assessment and oral alimentation tolerance were confirmed within 24h post procedure. According to our data, ping-pong skull fracture elevation using the vacuum method is a safe and satisfactory treatment in the neonatal period. Early treatment allows for quick resolution, and in our opinion is the strategy of choice for depressed skull fractures in newborns.

Facial dysmorphology in children exposed in pregnancy to anticonvulsant medications correlates with deficits in IQ.

Some children exposed at conception to the antiepileptic drugs (AEDs) phenytoin (PHT), phenobarbital (PB), and carbamazepine (CBZ) have changes in their midface and fingers. It has been suggested that the anticonvulsant-exposed child with these subtle changes in facial features (the "anticonvulsant face") has a greater likelihood of having deficits in IQ in comparison with children exposed to the same anticonvulsants who do not have these features. 115 AED-exposed children (40, PHT; 34, PB; and 41, CBZ) between 6.5 and 16 years of age and 111 unexposed children matched by sex, race, and year in school were evaluated. The evaluations were (WISC-III), physical examination with measurements of facial features and digits and photographs. The AED-exposed children had cephalometric radiographs, but not the unexposed. Each parent had a similar examination of face and hands plus tests of intelligence. These AED-exposed children showed an increased frequency of a short nose and anteverted nares, features of the "anticonvulsant face." Lateral skull radiographs showed a decrease in the angle between the anterior cranial base and nasal bone, which produces anteverted nares. Mean IQs were significantly lower on one or more IQ measures for the children with these facial features. Shortening of the distal phalanges and small fingernails correlated with the presence of a short nose in that child. The findings in 115 children exposed at conception to either phenytoin, phenobarbital, or carbamazepine, as monotherapy, confirmed the hypothesis that those with a short nose and anteverted nares had a lower IQ than exposed children without those features.

Attempted Suicide with a Self-Inflicted Penetrating Stab Wound to the Medulla Oblongata Caused by a Pair of Scissors: Case Illustration

A 78-year-old male patient with a history of psychotic depression was found in the bathroom of his apartment with a pair of scissors driven deeply into the back of his neck. He presented with tetraparesis with residual control over the left lower limb movement. Immediate skull radiograph and brain computed tomography scans revealed the tip of the scissors passing into the foramen magnum. Emergent surgery with midline suboccipital craniectomy and resection of the posterior arch of C1 was performed. The scissors were spontaneously dislocated in the course of surgery. Thereafter, debridement, placement of external ventricular drain and primary closure of the dura and skin were achieved. Post-operatively, the patient was not able to follow any instructions. On the 22nd post-operative day, the patient passed away in palliation. To our knowledge, this is the first reported case of a suicide attempt involving the use of scissors reaching the medulla oblongata.

Evaluation of age variation changes in cervical vertebrae: 2-Dimensional (2D) geometric morphometrics approach

Age estimation in adults is a complicated task because of various external factors occur concurrently with increasing age. The geometric morphometric method (GMM) is an approach that focuses on shape analysis and is widely recognized for its high reliability and reproducibility. The aim of this study was to explore the variation of cervical vertebrae among different age groups of the Malaysian population by GMM. Lateral skull radiographs of 432 subjects comprising four adult age groups; young adult age group (20–30 years old), early middle age group (31–40 years old), late middle age group (41–50 years old) and, elder adult age group (51–60 years old) were selected. Fifty-three 2-dimensional (2D) landmarks were applied to the digitalized radiographs by TPSDig2 (Version 2.31) software. Geometric morphometric analysis was performed by MorphoJ software. Results showed that the first three principal components (PC) contributed to 47.71 % of the cervical vertebrae variation and were shown in both lollipop and wireframe graphs. Procrustes ANOVA indicated that the shape was significantly different among different age groups. Canonical variate analysis revealed significant differences of both mahalanobis and procrustes distances among age groups with substantial individual overlap within groups. Discriminant function analysis (DFA) showed a correct classification rate for 61.5 % of cases respective to age groups. In conclusion, this study found significant differences in the shape of cervical vertebrae among different age groups of the Malaysian population using the GMM.

Sex Determination Using Frontal Sinus Diameters on Direct Radiography.

The shape and developmental stages of the frontal sinus (FS) differ in each individual, it can be used to determine sex and identity. This study aimed to assess the morphological structure of the FS diameters in sex determination using posterioanterior (AP) skull radiography. This data can be valuable for identifying and characterizing human features. The study included 350 patients (171 females, 179 males) aged between 20 and 55 years who underwent AP skull radiography. FSs were classified as symmetrical, asymmetrical, unilateral, or bilateral aplasic. The right and left FS height and width measurements were made based on the largest diameters. The mean age was 32.8±11.45 years for the whole sample. The mean age of the males was 31.23±11.9 (20-51) years and that of the females was 34.45±10.75 (20-55) years. When classified anatomically, 20 patients had bilateral aplasia (12 males,eight females), 19 patients had right aplasia (10 males, nine females), and 11 patients had left aplasia (seven males, four females). FS was symmetrical in 206 (72.1%) patients while right dominance was observed in 33 (9.43%) patients and left dominance in 61 (17.43%) patients. The FS height and width values on both sides ​​were statistically significantly higher in males than in females (p<0.001 for each parameter). The females were accurately classified at a rate of 71.2%and the males at 68.2%. Notably, our research has revealed that frontal sinus diameters are consistently larger in males than in females, and that direct radiography can be employed for gender determination with an accuracy rate of 69.7%. This information underscores the utility of morphometric evaluation of the frontal sinus diameters on direct radiography for gender and identity determination, potentially in conjunction with other parameters. In conclusion, our study has demonstrated the potential of the morphological structure of the frontal sinuses as a valuable tool for identifying and characterizing human individuals.