Palatine Sutures as Age Indicator: A Controlled Study in the Elderly

Abstract:  Vault sutures have proven their low reliability for estimating age at death in individual forensic science cases. We broke down the palatine sutures of 134 skulls (with known sex and age at time of death) into 15 subparts and 5 stages of fusion to obtain a mean coefficient of obliteration ( C p) which was then linked to five age classes. We completed this study with multiple regression equations of total palatine suture scores. We compared our results with those obtained using the Mann method on the one hand and classically segmented and scored ectocranial suture age determination methods on the other. Palatine sutures generally do not estimate age at death any better than cranial vault sutures. Despite the partly subjective aspect of suture study, palatine suture observation contributes additional information to age-range estimation, especially in old and very old subjects where other methods lose their effectiveness.     

颅顶矢状缝形态应用于个体识别初探

目的探讨颅顶缝应用于个体识别的可能性。方法观察和分析30例中国成年人颅骨及颅顶矢状缝。结果中国成年人颅顶矢状缝长度为109-136mm,与年龄、性别无关,顶孔出现率为80％,其中40％呈不对称性分布。结论颅项矢状缝具有个体识别的生物学特征;本文提出的颅顶矢状缝的观测方法简单易行。     

Ossification Degrees of Cranial Sutures Determined with Flat‐Panel Computed Tomography: Narrowing the Age Estimate with Extrema

Abstract: Since Broca’s time (1824–1880), ossification of the neurocranial sutures has been used as a characteristic of age. Current approaches include the visual macroscopic examination of ecto and endocranial sutures. The evaluation of the cross‐section of sutures usually necessitates the destruction of the neurocranium. In a nondestructive alternative approach that was tested within the context of the “Digital Forensic Osteology” project that ran in cooperation with the Virtopsy^®‐Project, it emerged that the resolution of conventional multi‐slice computed tomography data sets was not high enough to image sutures. Thus for the experiments presented here, the eXplore Locus Ultra flat‐panel computed tomography scanner from GE Healthcare was used. Calottes were scanned during autopsy and then immediately returned to the corpse. So far, the skullcaps of 221 individuals have been scanned. The cross‐sections of 14 suture segments could be assessed for seven previously defined stages of ossification. In a converse step, the 14 highest and lowest age estimate values corresponding to the individual stages of suture closure found were estimated for each calotte. The obtained ranges narrowing down the age estimate were evaluated with statistics. A mean value of 43.31 years for the range of narrowed age estimates shows that this method can be a useful aid in estimating age. The results of intra‐ and inter‐observer tests showed good overall agreement between the findings of three observers. This method is suitable for a nondestructive age estimation and can be used for the entire calotte.     

Time of closure of cranial sutures in northwest Indian adults

Time of closure of sagittal, coronal and lambdoid sutures was studied at autopsy in 538 male and 127 female adults of known ages belonging to Chandigarh zone of northwest India. The sagittal suture was divided into four segments and each side of the coronal and lambdoid sutures into three segments. Whether a segment was open or closed on either surface was recorded. On analysing the record, the authors came to the conclusions: (1) obliteration of sutures commences earlier in the males than in females, (2) suture obliteration starts earlier on endocranial surface than on the ectocranial and (3) commencement and complete obliteration of a segment or the entire suture is so erratic that it is not useful for estimating the age of a skull.     

Age-at-death estimation based on the study of frontosphenoidal sutures

Determination of age at the time of death based on the observation of cranial sutures has led to numerous studies with sometimes contradictory results. The initial hypothesis being that suture closure is part of an age-related physiological process, the conflicting results have been interpreted by various authors as secondary to the choice of sutures, under the co-existing influence of pathological factors or genetic factors, or even independent of age. Despite these differences, macroscopic methods remain much used in anthropology and in forensic medicine. In our work, we evaluated the value of the degree of closure of the frontosphenoidal suture in estimating age at death of mature subjects, with the secondary objective of establishing a linear regression which could be used in routine practice. The study concerned bone specimens from individuals whose age, sex and medical history were known. Macroscopic observation was carried out on the ectocranial and endocranial sides according to four stages of closure previously defined. 290 sutures were taken from a population of whom two-thirds were men. The method can be repeated and reproduced and the regression established shows the confidence range for average error to be +/-1.5 years. While this result is of interest in terms of precision in prediction for a group of people, the prediction range is too great (+/-23 years) to be applicable to a single individual as part of a forensic procedure.     

Cranial suture eccentricities: a case in which precocious closure complicated determination of sex and commingling

The union of the cranial sutures can follow a somewhat erratic course. While it is recognized that this can cause inaccuracies in estimating age at death, deviant closure patterns can influence assessments other than age. Premature or eccentrically fusing sutures can alter cranial growth and, therefore, shape. Such modified growth vectors can significantly influence metric analysis. A case is described in which precocious synostosis of the sagittal suture complicated determination of sex in a set of skeletalized remains. Features of the cranium and post-cranial skeleton indicated the individual was male, while the mandible, both metrically and morphologically, appeared to have come from a female. This led to the question of commingling. Techniques are described which were used to resolve these issues.     

Maxillary suture obliteration: a test of the Mann method

The degree of obliteration of the maxillary sutures has recently been presented as a useful technique for predicting the age at death of adult skeletal remains. A replicative study of the method on a sample of male skeletons of verified age was undertaken to test its accuracy. Results indicated that the variability in predicted age, as reflected by the total suture score, was too great to recommend use of the method for age determination in individual forensic science cases.     

Maxillary suture obliteration: a visual method for estimating skeletal age.

The purpose of this study was to develop a method of estimating the age of an individual based on obliteration of the four maxillary (palatal) sutures. A sample of 186 individuals of known age, race, and sex were examined. It was found that males of both races (black and white) exhibit more suture obliteration than females at the same age. During the early adult years, maxillary suture obliteration progresses at nearly the same rate in both sexes; however, the age of old individuals may be greatly overestimated using this method. Although this method cannot be used for exact estimates of individual age, it is valuable in establishing the age range, sorting commingled remains, and estimating skeletal age when only the maxilla is present.     

Current practices by forensic anthropologists in adult skeletal age estimation

When determining an age estimate from adult skeletal remains, forensic anthropologists face a series of methodological choices. These decisions, such as which skeletal region to evaluate, which methods to apply, what statistical information to use, and how to combine information from multiple methods, ultimately impacts the final reported age estimate. In this study, a questionnaire was administered to 145 forensic anthropologists, documenting current trends in adult age at death estimation procedures used throughout the field. Results indicate that the Suchey-Brooks pubic symphysis method (1990) remains the most highly favored aging technique, with cranial sutures and dental wear being the least preferred, regardless of experience. The majority of respondents stated that they vary their skeletal age estimate process case-by-case and ultimately present to officials both a narrow and broad possible age range. Overall, respondents displayed a very high degree of variation in how they generate their age estimates, and indicated that experience and expertise play a large role in skeletal age estimates.     

Surgical Sutures as a Means of Identifying Human Remains*

Abstract: The Food and Drug Administration does not require surgical sutures to be tracked by manufacturer, physician, or patient; thereby, surgical sutures have been of little use to forensic practitioners who are tasked with establishing a positive identification with biological evidence. This study demonstrates the investigative process used to pinpoint suture manufacturers by presenting a case where surgical sutures were a distinctive characteristic that aided in the positive identification of skeletal remains. The suture’s manufacturer, construction material and structure, size, and medical use was determined by contacting a local surgical suture and orthopedic implant manufacturer and utilizing publicly available manufacturer websites, which provide catalogs and specific product details. This research was one of many lines of evidence used to establish the positive identification of a 47‐year‐old male.     

颅内外骨缝推断年龄的探讨

本文报告16～92岁的140例颅骨的颅内外冠状缝、矢状缝、人字缝的愈合情况。骨缝愈合的主要影响因素为身长、颅外冠状缝右侧第3部(P相似文献   

Listing of color additives for coloring sutures; [phthalocyaninato(2-)] copper. Food and Drug Administration, HHS. Final rule

The Food and Drug Administration (FDA) is amending the color additive regulations to provide for the safe use of [phthalocyaninato(2-)] copper in coloring nonabsorbable sutures for general and ophthalmic surgery made from a blend of poly(vinylidene fluoride) and poly(vinylidene fluoride-co-hexafluoropropylene). This action responds to a petition filed by Ethicon, Inc.     

Geographic Variation in Zygomaxillary Suture Morphology and its Use in Ancestry Estimation

Angled/curved zygomaxillary suture coding is widely employed in cranial assessments of ancestry. However, the efficacy of this method has not been extensively evaluated across diverse populations. In this study, zygomaxillary suture morphology was assessed on a total of 411 human crania from six populations (European, Native American, African, Asian, Arctic Circle, and Aboriginal Australian) using a novel 3D coordinate landmark method. Our results indicate a predominance of angled sutures among native peoples of the Arctic and North America (85–86%), a prevalence of curved sutures among Africans and Aboriginal Australians (77–81%), and essentially equal proportions of both configurations in Asians and Europeans (50–56%). Statistically, angled/curved coding generally discriminates poorly between groups, except when populations with antithetically high frequencies of the two configurations (e.g., African vs. Native American) are compared. Moreover, comparisons across previous studies reveal conflicting frequencies for many populations, further suggesting limited utility of this trait in ancestry estimation.     

头颅放射影像资料的同一认定

利用放射影像资料进行法医临床学鉴定案例越来越多。同一认定常使用的标志包括牙齿、头颅、脊柱等相关特征结构。头颅放射影像资料,包括X片及CT片中的额窦、乳突、蝶鞍、颅缝及其他结构均可作为同一认定的标志。目前,我国法医放射学尚属起步阶段,应加强此方面的研究。     

Gunshot wound with asphalt related pseudo-soot, pseudo-tattooing, and pseudo-scorching

Artifacts which mimic the tattooing and soot deposition of close range gunshot wounds have been described as "pseudo-soot" and "pseudo-tattooing." The origin of such findings includes glass, intermediate targets, insect bites, medical manipulation, graphite, and sutures. The authors present a case of pseudo-soot and pseudo-tattooing as a result of asphalt pavement, and describe the associated entity of pseudo-scorching.     

Zygomaticomaxillary suture shape analyzed with digital morphometrics: reassessing patterns of variation in American Indian and European populations

Typological classification of human zygomaticomaxillary suture (ZMS) shape is often used in forensic assessment of ancestry, following earlier studies reporting higher frequencies of "angled" sutures among American Indians and higher frequencies of "curved" sutures among Caucasians. In this paper we present a new method of digital morphometrics to quantify and compare ZMS shape in 60 American Indian and 60 European crania. Suture outlines were recorded as three-dimensional (3D) contours on digital models of adult male and female crania created with a portable 3D laser scanner. Each contour was represented by about four hundred point coordinates, which were transformed via Fourier analysis into amplitude coefficients suitable for use in linear discriminant analysis. Discriminant functions were created that accurately predicted group membership for 83% of the crania in the sample, after leave-one-out cross-validation. The results were compared with traditional typological classifications based on visual evaluation of ZMS shape, and the contour-based method was found to be more effective than the typological approach. However, the distribution of ZMS types within the two sample groups did not conform to previously reported patterns. This discrepancy indicates that ZMS shape may reflect not only genetic factors, but also environmental factors such as diet and stress. In addition, some evidence for sexual dimorphism in the zygomaticomaxillary complex was observed. Based on these findings, we recommend caution when using ZMS shape analysis in forensic ancestry determination.     

Evaluation of pediatric skull fracture imaging techniques

Radiologic imaging is crucial in the diagnosis of skull fracture, but there is some doubt as to whether different imaging modalities can accurately identify fractures present on a human skull. While studies have been performed to evaluate the efficacy of radiologic imaging at other anatomical locations, there have been no systematic studies comparing various CT techniques, including high resolution imaging with and without 3D reconstructions to conventional radiologic imaging in children, we investigated which imaging modalities: high-resolution CT scan with 3D projections, clinical-resolution CT scans or X-rays, best showed fracture occurrence in a pediatric human cadaver skull by having an expert pediatric radiologist examine radiologic images from fractured skulls. The skulls used were taken from pediatric cadavers ranging in age from 5 months to 16 years. We evaluated the sensitivity and specificity for the imaging modalities using dissection findings as the gold standard. We found that high-resolution CT scans with 3D projections and conventional CT provided the most accurate fracture diagnosis (single-fracture sensitivity of 71%) followed by X-rays (single-fracture sensitivity of 63%). Linear fractures outsider the region of the sutures were more identifiable than diastatic fractures, though the incidence of false positives was greater for linear fractures. In the two cases where multiple fractures were present on the same anatomical skull location, the radiologist was less likely to identify the presence of additional fractures than a single fracture. Overall, the high-resolution and clinical-resolution CT scans had the similar accuracy for detecting skull fractures while the use of the X-ray was both less accurate and had a lower specificity.     

Postmortem analysis of anastomotic suture line disruption following carotid endarterectomy

The tensile strength of a surgical suture is essential in maintaining the integrity of vascular anastomoses. While faulty operative technique and the loading strength of individual sutures have been implicated in spontaneous suture line disruptions, there has, to date, never been a published postmortem analysis of a suture that has known to have failed. We present the case of suture line disruption leading to fatal exsanguination in a 77-year-old man following carotid endarterectomy with a facial vein patch. Using both dissecting and scanning electron microscopy, we determined that surgical technique (an untied knot) was the cause of the suture line disruption. The removal of a broken or untied suture at surgery or at autopsy should not preclude proper analysis of the failed suture, because the results can have both medico-legal and public health implications.     

Experimental studies of skull fractures in infants

According to pediatric statements, falls from a standing position may cause skull fractures in infants without specific symptoms. Nearly every infant has at some time fallen from the changing table or the baby carriage, etc. From the forensic aspect it is the duty of experts to discuss the "battered child syndrome." Evidence given by the defendants concerning the height of the fall are unreliable. Experimental test series concerned with the stumbling height (82 cm in free fall) and three various types of floor-stone, carpet, and foam-backed linoleum -were carried out. In each case skull fractures were seen. In three cases the fractures crossed the sutures. Conclusions: (1) Each fall of an infant from the height of a table may cause a skull fracture, which may lead to death; (2) when child mishandling is suspected, all circumstances must be taken into consideration.     

Positive identification by a skull with multiple epigenetic traits and abnormal structure of the neurocranium, viscerocranium, and the skeleton

Wormian bones are small ossicles appearing within the cranial sutures in more than 40% of skulls, most commonly at the lambdoid suture and pterion. During the skeletal analysis of an unidentified male war victim, we observed multiple wormian bones and a patent metopic suture. Additionally, the right elbow was deformed, probably as a consequence of an old trauma. The skull was analyzed by cranial measurements and computerized tomography, revealing the presence of cranial deformities including hyperbrachicrania, localized reduction in hemispheral widths, increased cranial capacity, and sclerosis of the viscerocranium. Besides unique anatomical features and their anthropological value, such skeletal abnormalities also have a forensic value as the evidence to support the final identification of the victim.