Identification by frontal sinus pattern in forensic anthropology

The authors report forensic cases from the literature, as well as two personal homicide cases, of identification through comparison of frontal sinus radiographs. A general discussion about identification using frontal sinus X-rays is presented, pointing out the reliability of the method, in reference to the uniqueness of the frontal sinus in humans, but also some difficulties, especially in reference to the distance, orientation and angle of the X-ray technique.     

The impact of Daubert: implications for testimony and research in forensic anthropology (and the use of frontal sinuses in personal identification)

This paper emphasizes the need for objectivity and standardized methodologies in the forensic sciences, particularly physical anthropology. To this end, a review of important events in scientific evidence admissibility law, particularly the standards set in the case of Daubert v. Merrell-Dow Pharmaceuticals, Inc., 1993, is presented. The method of confirming a putative identification by visual comparison of antemortem and postmortem frontal sinus radiographs is examined in light of current admissibility standards. The technique is revealed to have a number of shortcomings, including a lack of empirical testing, no estimates of potential error rates, no standards controlling the technique's operation, and no objective determination standards. These shortcomings may, in some instances, prevent resulting conclusions from being admissible evidence. It is suggested that some methods (including frontal sinus comparison) may require more rigorous testing in order to meet these new and stricter standards.     

The Reliability of Visually Comparing Small Frontal Sinuses*

Abstract: Several studies have investigated frontal sinus comparison for personal identification. One study addressed the statistical reliability of correct identification using automated digital methods and resulted in a 96% accuracy rate. Missed matches with the digital methods generally involved small, less featured sinuses. This study investigates the hypothesis that human examiners may be able to more accurately identify correct matches than digital methods, even when the comparisons involve small frontal sinuses. Participants were provided two sets of 28 radiographs and were instructed to identify matching radiographs and list the radiographs that did not have a corresponding match. Overall, error rates were low, with correct associations identified at a rate of 0.983. No incorrect associations (“false positives”) were made. Correct association rates were highest among participants “experienced” examining radiographs. Results support previous assertions that frontal sinus radiographs are a reliable means of personal identification even when the frontal sinuses are small.     

Assessing forensic applications of the frontal sinus in a Chinese Han population

The frontal sinus is an important tool of personal identification. To assess the forensic applications of the frontal sinus patterns in a Chinese Han population, 198 individuals were analyzed. 165 individuals who have the frontal sinus were observed in this population, and 12 parameters of the frontal sinus were observed according to Yoshino’s method. The same combined code was found in three persons from our samples. The unilateral frontal sinus scalloped with one arcade has few parameters applied to personal identification, and shows the poorer discrimination power. These parameters showed better discrimination power in our population, and could be applied to personal identification.     

利用额窦影像进行个体识别的研究进展

鉴于额窦不规则气腔形态的高度特异性、成熟后形态不变的稳定性以及放射学技术在临床的广泛应用,额窦影像已成为法医学个体识别的重要研究对象.利用额窦影像进行个体识别已具有法庭意义.当DNA和指纹等传统个体识别方法应用受限或无法有效进行,或缺乏相应的牙科记录等情况时,额窦影像对比是有效的个体识别替代方法.多种影像资料都可用于额...     

Skeletal identification using the frontal sinus region: a retrospective study of 39 cases

The importance of identification using the frontal sinus has been previously demonstrated in case reports. In this study, 39 cases of identification using frontal sinus comparison from the Ontario Chief Coroner's Office were reviewed and differences between antemortem and postmortem radiographs examined. All cases involved decedents older than twenty years. Three cases were rejected due to poor antemortem and postmortem film quality. One subject had no frontal sinus. Thirty-five cases provided conclusive postmortem to antemortem pattern matches. Sixteen cases also yielded metric (quantitative) matches. Duration between antemortem and postmortem radiographic examinations, age, gender, and cause of death did not affect the ability to obtain a match. This is the largest study undertaken on actual cases and demonstrates the validity of frontal sinus pattern matching for forensic identification.     

Post-mortem radiological CT identification based on classical ante-mortem X-ray examinations

Radiological identification is important in forensic medicine. Identification using comparison of individualising structures with ante- and post-mortem conventional radiographs has been known for a long time. New radiological procedures such as computed tomography (CT) and magnetic resonance imaging (MRI) are being increasingly used for identification. In this paper, a new comparative approach using various radiological methods is described and its application demonstrated. This new approach is the comparison of ante-mortem conventional radiographs with projected images calculated from post-mortem CT data. The identification procedure will be illustrated with reference to the frontal sinus and the pelvis.     

Identification Using Frontal Sinus by Three‐Dimensional Reconstruction from Computed Tomography*

Abstract: Radiographs and computed tomography (CT) images have been increasingly applied and accepted in forensic sciences. Along with radiographs and CT images, the frontal sinus is often used for the individual identification because of its unique and unchangeable characteristics. The purpose of this study is to define the usefulness of three‐dimensional (3‐D) images of the frontal sinus for identification. CT images from 119 Korean cadavers were built up for 3‐D reconstruction and surveyed with 15 measurements. The total volume of the sinus, some nonmetric characteristics, and the bilateral asymmetry index in men differed significantly from those in women (p < 0.05). The digit codes, six sections and 10‐digit number, were almost able to accurately identify individuals (98%). This study showed a statistical difference between the sexes and classified the fused and prominent middle sinuses for the first time. This proposed method for identification is more accurate than those used in other studies.     

Validation of chest X-ray comparisons for unknown decedent identification

Comparing skeletal structures between antemortem and postmortem chest radiographs is widely used by forensic specialists from many disciplines to positively identify unknown decedents. However, validity assessments of this method have been fairly limited. This study had three objectives: 1) to quantify the reliability of ante- and postmortem chest radiograph comparison for decedent identification; 2) to identify useful radiologic features supporting decedent identification; and 3) to recognize sources of error in decedent identification related to use of comparative radiographs. A forensic pathologist, a forensic anthropologist, and two radiologists participated in the study. Our results showed that chest radiograph comparisons proved reliable, if basic decedent information was provided, and antemortem and postmortem radiographs were adequately positioned and exposed. A "morphological approach" using normal anatomical structures for comparison may provide the most efficient method for accurate identification.     

The diversity of adult dental patterns in the United States and the implications for personal identification

Few would argue about the individuality of dental radiographs for forensic identification, but when an antemortem/postmortem comparison is based strictly on dental treatment notes and/or charts it becomes less certain. In the past, attempts to validate the high diversity of dental patterns created by combinations of missing, filled, and unrestored teeth have been based on unfounded statistical assumptions. The goal of this research is to present a statistically valid method of assessing dental pattern diversity for the identification of missing individuals. Empirical observation of large reference datasets was found to be the best technique for assessing dental diversity. This technique is nearly identical to the procedure used for mitochondrial DNA casework. For the research presented in this paper, two large datasets were used, one composed of U.S. military personnel and one composed of U.S. civilians. Dental patterns were found to be very diverse on a scale that is comparable to mtDNA. In addition, it was found that the diversity values remain very consistent regardless of the level of detail present in the treatment records. Overall, combinations of missing, filled, and unrestored teeth were found to be very individualistic and an excellent source for forensic identification.     

Dental identification by comparison of antemortem and postmortem dental radiographs: influence of operator qualifications and cognitive bias

Dental forensic identifications based on comparison of antemortem and postmortem radiographs provide effective and reliable evidence. There are no standardized procedures for assessing similarities between different types of dental radiographs (e.g. orthopantomograms, bitewings, and periapical radiographs), and the operator's subjective judgment can considerably affect identification. The purpose of this study is to evaluate the potential influence of experts' qualifications, training, and cognitive bias on the accuracy of identification. Seventy-eight differently qualified and experienced experts underwent an identification test. The expert sample was composed of 10 specialists in emergency care (ER), 10 specialists in legal medicine (ML), 20 pregraduate dental students (STU), 12 dentists (DENT), 20 dentists educated in forensic odontology (DENT-TRA), and 6 experienced forensic odontologists (FOR). The simulated cases required participants to assess the possible matching of 42 postmortem intraoral radiographs with 16 antemortem panoramic radiographs. Accuracy and specificity for the different operator groups were as follows: ER, 0.76-0.70; ML, 0.76-0.88; STU, 0.89-0.82; DENT, 0.87-0.97; DENT-TRA, 0.88-0.92; and FOR, 0.97-1. As evidenced by high rates of accuracy and repeatability, the most experienced forensic odontologist consistently outperformed operators less or differently educated and trained, especially for difficult cases. In our sample, the dentists who received additional education in forensic odontology did not necessarily perform better than dentists who had not received this additional education. Some cognitive bias, mainly the so-called observer effect, emerged as a possible source of outcome variability among the operator groups.     

DNA collection from used toothbrushes as a means to decedent identification

ABSTRACT: Comparison of DNA profiles is often used in verifying the identification of deceased human beings when other easier, quicker, and less expensive means to identification are not possible. Fifty-five adult subjects divided into 3 groups provided a used toothbrush along with a small bloodstain control for DNA analysis and comparison. Results indicate that there is no significant difference in the quantity and quality of DNA recovered from a toothbrush that has been used for 1 month versus 3 months versus random periods. The results of this study confirm earlier conclusions that a used toothbrush is a reliable source of antemortem DNA from a putative decedent. The use of aviation snips to remove a small portion of the toothbrush head provides an easy, inexpensive method of obtaining a sample for DNA extraction. The authors recommend this method as a standardized technique for use in forensic DNA laboratories.     

The reliability of digitized radiographs for dental identification: a Web-based study

In the era of Daubert and other judicial rulings pertaining to the acceptability of forensic evidence, it is increasingly important that experts are able to testify that their methods have been scientifically tested and that error rates and other factors relating to reliability have been published. The purpose of this study was to determine the reliability of digitized radiographic comparisons for the purposes of dental identification. Participants with various forensic backgrounds and experience levels were passively recruited to the website. Ten forensic identification cases composed of antemortem and postmortem dental radiographs were supplied to examiners using a bespoke website. Participants responded to the cases on two occasions after a one-month washout interval using the ABFO conclusion levels for forensic identifications. A total of 115 first attempts and 87 matched second attempts were received. Of the total responses, 72% were dentally trained respondents who had completed at least one forensic identification case; of these, 38% were experienced forensic dentists who had completed more than 25 identifications. Data relating to accuracy, intra- and inter-examiner agreement, and the effect of case difficulty are presented. Mean accuracy was 85.5% for all cases, with the experienced forensic dentists obtaining a 91% success rate. The inter-examiner agreement on the negative identification cases was classified as poor. The data suggest that dental identifications resulting from the comparison of postmortem and antemortem radiographs are valid, accurate, and reliable when undertaken by experienced odontologists.     

A New Digital Method for the Objective Comparison of Frontal Sinuses for Identification*

Abstract: Use of the frontal sinuses for identification requires an objective method of comparison to meet Daubert standards. Christensen’s application of Elliptical Fourier Analysis and Likelihood Ratios seems to be a viable solution for this problem. The proposed method draws upon this work and attempts to simplify its application. Variation between pairs of digitized sinus tracings was quantified by summing the difference between corresponding measurements taken from a fixed origin to the outer edge of the sinus outlines using Adobe Photoshop^® CS2. Same‐skull and different‐skull pairs were used to develop reference distributions from which the probability of unknown pairs coming from the same or a different individual was estimated. Error rates of 0% were achieved. Resulting correlation coefficients demonstrated inter‐rater and test–retest reliability. Further refinement of the reference distributions and more rigorous testing of error rates should make this technique applicable to casework.     

A Radiographic Study on the Utility of Cranial Vault Outlines for Positive Identifications

A standard method for positive identification is the use of antemortem and postmortem radiographic comparisons. The purpose of this research is to test the visual accuracy of antemortem and postmortem radiographic comparisons of cranial vault outlines and to evaluate their uniqueness using geometric morphometric methods. A sample of 106 individuals with varying levels of education and forensic case experience participated in a visual accuracy test. Of the 106 individuals, only 42% correctly assigned all of the radiographs, with accuracy rates ranging from 70 to 93% for each radiographic comparison. Vault shape was further examined using elliptic Fourier analysis, and paired t‐tests were computed on the first 10 principal components accounting for 100% of the variance, which found no significant differences. The visual accuracy test and elliptic Fourier analysis shows that vault outlines may not be unique enough for positive identifications when used as a sole indicator.     

中国四川省汉族人群额窦CR片的同一认定

目的研究不同投照体位CR片上额窦用于同一认定的观测指标,以编制特异的识别编码.方法用两宽度比值与形态学描述相结合的方法观测额窦CR片,并采用描述性研究方法进行描述性研究和统计分析.结果以额窦不对称性AI、额窦与眼眶宽度之比RI、最大额窦宽度的侧别、额窦上缘弓形弯曲数目(左侧、右侧)、额窦部分隔数目(左侧、右侧)、额窦中间隔位置等8项指标,编制8位数字的额窦构型同一认定编码;额窦形态性别差异无统计学意义(P＞0.05).结论额窦形态高度个人特异,可以用于同一认定,但不能用作性别判断.     

Craniofacial identification by comparison of antemortem and postmortem radiographs: two case reports dealing with burnt bodies

Two cases of positive identification of burnt bodies by radiographic comparison are reported. They emphasize that antemortem radiographs of the head are an important but sometimes overlooked source of information which can frequently provide useful objective data for comparison purposes. A positive identification can easily be achieved by medical examiners through visual comparison of the antemortem with the postmortem cranial and facial structures, even of bodies severely damaged by fire. In these bodies the radiographs of the skull can graphically depict structures which are often unique to the individual, such as the frontal sinus pattern and the morphology of dental restorations. However, the process of identification through radiographs is appropriate only in burnt bodies in which antemortem radiographs of the alleged deceased are available for comparison and unique craniofacial structures are still present on the body in a well-preserved state or at least not completely destroyed by fire, depending on the extent of the burn injury. Matching of corresponding features seems preferable to other methods of personal identification such as skull-photo superimposition, morphometric analysis, and/or other computer-aided methods since these techniques need trained personnel, as well as expensive equipment which is not invariably available in the medical examiner's office or department of anthropology.     

医学影像资料法医学同一认定30例分析

目的探讨医学影像资料法医学同一认定的鉴定原则、思路及方法。方法总结华西法医学鉴定中心1992—2012年受理的30例医学影像资料同一认定案例,对影像资料数量、种类,鉴定利用的识别点及其类型、间隔进行回顾性统计分析。结果胸部X线片为最常见的鉴定资料类型。利用的识别点共有33处、6种类型,包括：自身惟一性特征、骨骼自身结构的变异或发育畸形、疾病或退行性变、创伤后病理变化、医疗后果和正常形态的多处一致。结论影像资料常规审查是案件受理前提之一,同一认定时结合资料类型、投照部位及案情特点选择相应识别点,自身惟一性识别点最佳,多种类型识别点联合使用,识别点多处表现一致得出肯定结论者可应用于鉴定实践。     

额窦数字X线影像分型与同一认定指标的筛选

目的 从法医学同一认定的视角探究柯氏位额窦计算机X线摄影(computer radiography,CR)的形态学分类,并结合识别指标的数字编码,构建X线影像同一认定体系.方法 收集 400例四川汉族成年人额窦标准柯氏位CR片.以两侧眼眶上缘均相切的直线与额窦的位置关系对额窦形态学特征进行分型研究,并对额窦识别指标进行数字编码.结果 提出额窦CR片影像学特征6类分型,筛选出额窦不对称性、最大额窦面积的侧别、同侧额窦面积与眼眶面积比、额窦上缘弓形弯曲数、额窦部分分隔位置、额窦中间隔位置等8项识别指标.结论 提出了先作分型鉴别,再用所选取的8项指标对额窦形态进行识别编码的柯氏位额窦CR片影像同一认定的新思路.