Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences.

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Dense bones, such as the maxilla, surpass this challenge and remain intact with sinuses even after incineration, thereby making the sinuses an ideal and reliable forensic science tool. No-ninvasive imaging techniques, such as Computed Tomography (CT), can be used to evaluate such cases and help detect fractures and further locate foreign bodies. This study aimed to estimate the dimensions and volumes of the frontal (FS), maxillary (MS), and sphenoidal air sinuses (SS) on CT scans and investigate age- and sex-related differences. Methods CT scans of the paranasal sinuses were acquired from 158 patients ranging in age from 19 to 73 years, and written consent was obtained from all participants. This study was approved by the Institutional Ethical Committee (ethical clearance number IEC 064/2010). All parameters were statistically analyzed using SPSS 20 version and the significance level was set at p<0.05. Results The bilateral anteroposterior length and height of the FS were significantly larger in men than females (p<0.05). The overall dimensions of the MS and SS were substantially greater in males than females (P <0.05). Likewise, the overall volumes of the fFS, MS, and SS were significantly greater in males than females (p<0.05). However, no significant age-related correlation was observed in the dimensions and volumes of the sinuses. Conclusion The results of this study showed that imaging could be a reliable instrument for personal identification in forensic anthropology. Countries that do not allow autopsies may implement this method to clarify the cause of death. 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F1000Research 2025, 14 :85 ( https://doi.org/10.12688/f1000research.156445.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] Anu Vinod Ranade 1,2 , Rajalakshmi Rai https://orcid.org/0000-0003-0776-2254 3 , Biswabina Ray 4 , Soumya Vinod https://orcid.org/0000-0002-7961-9396 5 Anu Vinod Ranade 1,2 , Rajalakshmi Rai https://orcid.org/0000-0003-0776-2254 3 , Biswabina Ray 4 , Soumya Vinod https://orcid.org/0000-0002-7961-9396 5 PUBLISHED 15 Jan 2025 Author details Author details 1 Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates 2 Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates 3 Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangaluru, Karnataka, India 4 Department of Anatomy, AIIMS, Kalyani, West Bengal, 741245, India 5 Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates Anu Vinod Ranade Roles: Conceptualization, Formal Analysis, Methodology, Resources, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Rajalakshmi Rai Roles: Methodology, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Biswabina Ray Roles: Data Curation, Supervision, Validation, Visualization Soumya Vinod Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Background The identification of an individual after mass calamities poses challenges to experts when bones are fragmented. Dense bones, such as the maxilla, surpass this challenge and remain intact with sinuses even after incineration, thereby making the sinuses an ideal and reliable forensic science tool. No-ninvasive imaging techniques, such as Computed Tomography (CT), can be used to evaluate such cases and help detect fractures and further locate foreign bodies. This study aimed to estimate the dimensions and volumes of the frontal (FS), maxillary (MS), and sphenoidal air sinuses (SS) on CT scans and investigate age- and sex-related differences. Methods CT scans of the paranasal sinuses were acquired from 158 patients ranging in age from 19 to 73 years, and written consent was obtained from all participants. This study was approved by the Institutional Ethical Committee (ethical clearance number IEC 064/2010). All parameters were statistically analyzed using SPSS 20 version and the significance level was set at p<0.05. Results The bilateral anteroposterior length and height of the FS were significantly larger in men than females (p<0.05). The overall dimensions of the MS and SS were substantially greater in males than females (P <0.05). Likewise, the overall volumes of the fFS, MS, and SS were significantly greater in males than females (p<0.05). However, no significant age-related correlation was observed in the dimensions and volumes of the sinuses. Conclusion The results of this study showed that imaging could be a reliable instrument for personal identification in forensic anthropology. Countries that do not allow autopsies may implement this method to clarify the cause of death. READ ALL READ LESS Keywords air sinuses, forensic anthropology, morphometry, computed tomography, imaging. Corresponding Author(s) Soumya Vinod ( [email protected] ) Close Corresponding author: Soumya Vinod Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Ranade AV et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Ranade AV, Rai R, Ray B and Vinod S. Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.12688/f1000research.156445.1 ) First published: 15 Jan 2025, 14 :85 ( https://doi.org/10.12688/f1000research.156445.1 ) Latest published: 15 Jan 2025, 14 :85 ( https://doi.org/10.12688/f1000research.156445.1 ) Introduction “Nothing else will matter until she has a name,” a poignant observation by the renowned anthropologist Kathy Reich underscores the critical importance of personal identification in forensic investigations. 1 Establishing a victim’s identity, particularly following a mass disaster, presents a formidable challenge for forensic experts because of the overwhelming number of casualties and limitations of available resources. 2 A general guideline emphasizes the urgency of prompt victim identification because delays can significantly compromise the accuracy of this process. 3 Moreover, identifying the deceased holds profound significance for grieving family members, friends, and relatives. 3 To initiate the identification process, the first step involves assessing the body’s sexual dimorphism and age. 4 , 5 While traditional methods, such as fingerprinting and DNA analysis, offer accurate results, they can be time-consuming and require specialized laboratories and equipment. These techniques may also be impractical when the body undergoes significant decomposition. 6 Forensic experts frequently utilize intact skeletal remains from the skull, pelvis, and long bones to determine the age and sex of victims. 7 However, in mass disasters such as tsunamis, earthquakes, explosions, and aircraft crashes, forensic experts may encounter fragmented skeletal remains. 7 The distinctive characteristics of certain bones, including the maxillary and zygomatic bones, can mitigate these challenges. Even in incineration cases, the sinuses of these bones may remain intact, rendering their dimensions a valuable and reliable tool for forensic identification. 8 Furthermore, maxillary sinus (MS) pneumatization differs between people, and its volume is affected by age. 9 Frontal sinuses (FS) are unique even amidst monozygotic twins, are unchangeable and persistent, and have sturdy walls that remain undamaged in human corpses. 6 , 10 The sphenoid sinus (SS) pneumatization pattern varies in proportion and direction, and based on these anatomical features, it is used by clinical researchers in forensic investigations. 11 Additionally, detailed anatomical knowledge of the normal sinuses and their variants plays a vital role in avoiding complications during functional endoscopic sinus surgeries. 10 The utilization of cross-sectional imaging modalities, such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), CT angiography, and imaging-guided biopsy, has resulted in significant advancements in the medico-legal field, particularly with regard to identifying human remains. 12 – 14 CT imaging allows for precise positioning and measurement of anthropometric points within the skull as well as the calculation of volumes and areas. 14 These images may be compared to antemortem records, such as medical or dental records, to establish positive identification. 15 Moreover, these noninvasive techniques enable the re-evaluation of cases and can assist in detecting air embolisms, fractures, and locating projectiles and foreign bodies. 12 , 16 – 18 Paranasal sinus analysis can also be used in conjunction with other methods of identification, such as DNA analysis or dental records, to strengthen identification. 19 It is also a non-invasive method of identification that does not require the removal of tissue or disturbance of the body. In countries where autopsies are not permitted, this method can be implemented to document potential injuries and elucidate the manner and cause of death. 20 As data related to skeletal measurements of air sinuses in deceased individuals are limited, recent studies have been conducted within the living population to record discriminant age- and sex-based data. 21 Given the diverse importance of the morphometry of the air sinuses, this study aimed to measure the dimensions and volumes of the FS, MS, and SS air sinuses on CT scans, as well as to investigate age- and sex-dependent differences. Methods Ethical approval was obtained from the Manipal Academy of Higher Education through its’ Institutional Ethics Committee (Ethical clearance/ref no: 064). Prior to the study, all participants were requested to provide written consent for the use of their anonymized data in future research and publication. This study utilized a retrospective cross-sectional design based on the STROBE guidelines {Cuschieri, 2019 #1}. Cranial CT images were obtained from158 patients of varying ages (19-73years), consisting of 79 males and 79 females, from whom prior consent was obtained. The sample size was determined using the calculation reported by Buyuk et al. 22 For morphometric measurements, patients with normal bony margins and paranasal sinuses without any signs of inflammation were included for volume measurements were included in the study. Patients with damaged bony margins and those with sinonasal pathologies, such as inflammatory changes or space-occupying lesions, were excluded. A 64-row detector Philips Brilliance CT scanner was used to perform CT scans of the sinonasal region in a tertiary hospital. The helical CT study utilized a high-resolution bone algorithm with the following parameters: Pitch, 64×0.625:0.64, rotation: 0.5/sec, Fov: 180 mm, filter: bone (D), enhancement: nil, window: C200 W2000, matrix: 512, slice thickness: 0.9 mm, increment: 0.45 mm, KV: 120, mAS\slice: 100. The data obtained from the scan were isotropic, enabling further post-processing morphometry investigation. Sinus morphometric data were obtained by reforming the scans in the axial, sagittal, and coronal planes using isotropic volumetric data. Axial reformation was performed with the plane of reformation parallel to the hard palate, coronal reformation plane perpendicular to the vomer, and sagittal reformation plane parallel to the vomer. The maximum anteroposterior (AP) length, maximum vertical height, and maximum width of the FS, MS, and SS were assessed using “Dicom software,” and the values were expressed in millimeters. Measurements of the FS, MS, and SS were obtained using DICOM software and expressed in millimeters. The maximum anteroposterior (AP) length was measured in the axial plane ( Figure 1A , 1B , and 1C ), while the maximum vertical height ( Figure 2A , 2B , and 2C ) and width ( Figure 3A , 3B , and 3C ) were assessed in the coronal plane. Figure 1. (A,B,C): Axial CT image showing the AP measurement of FS, MS and SS respectively. (RAPL- right anteroposterior length; LAPL- left anteroposterior length). Figure 2. (A, B, C): Coronal CT images showing the height of FS, MS, and SS, respectively. (RH, right height; LH, left height). Figure 3. (A, B, C): Coronal CT image showing width measurements of FS, MS, and SS, respectively. (RW: right width; LW: left width). In the case of the FS, the AP length was measured from the most anterior to the most posterior point on the sinus in the axial plane ( Figure 1A ), and the height was calculated from the lowest to the highest point on the coronal plane sinus ( Figure 2A ). Width was measured as the longest distance between the medial and lateral points in the coronal plane ( Figure 3A ). For the MS, AP length was measured from the anterior-most point to the posterior-most point along the medial wall of the sinus in the axial plane ( Figure 1B ). The height was measured from the bottom-most point on the sinus floor to the uppermost end of the roof of the sinus in the coronal plane (2 B), while the width was taken as the longest distance between the medial and lateral walls of the coronal plane’s sinus (3 B). For the SS, the septum was considered as the border between the two sinuses. AP length, height, and width were measured from the anterior-most point to the posterior-most point in the axial plane ( Figure.1C ), the lowest to the highest point in the coronal plane ( Figure 2C ), and the medial-most point in the coronal plane ( Figure 3C ). The volumes of all three sinuses were calculated using the volume tracing tool software. A dye was injected into the sinus cavity for segmentation, and three-dimensional reconstruction of the filled sinus cavity was performed to calculate the volume of the sinus, which was expressed in cubic centimeters ( Figure 4A , 4B , and 4C ). Figure 4. (A, B, C): Axial CT scan depicting volume measurement of the right frontal sinus (FS), maxillary sinus (MS), and sphenoid sinus (SS) using contrast dye injected into the sinus cavities. Statistical analysis Pearson’s correlation test was applied to establish the correlation of the dimensions and volumes of the frontal, maxillary, and sphenoid sinuses with age. Independent samples t-test was used to compare sex, and statistical significance was set at p<0.05. The analysis was conducted using IBM SPSS 20.0 (IBM Inc., Chicago). Results The descriptive statistical mean, standard deviation, and ‘P’ value using Student’s t-test for independent samples are tabulated in Figure 5 , representing volume, and Figure 6 , representing dimensions. Figure 5. Volumes of frontal, maxillary and sphenoidal sinuses in both sexes. Figure 6. Dimensions of frontal, maxillary and sphenoidal sinuses in both sexes. The AP length and height of the FS on both the right and left sides were greater among males (17.1±6.9; 21.9±7.9 and 18.6±6.4; 24.4±9.2 mm) than in females (14.6±5.6; 19.1±13.7; and 15.5±6.4; 17.2±6.9 mm). The mean AP length of the FS on both sides was significantly greater in males than in females (p<0.05). The mean heights of the FS on the right and left sides were larger in males than females, and the difference was significant on the left side (p<0.001). In addition, the mean width of the FS bilaterally was greater in males compared than in females, although this difference was not statistically significant. We also found that the AP length, height, and width of the MS on the right and left sides were significantly greater in males (40.0 ±3.1; 39.5±5.1; 29.8±5.1 mm and 40.4±4.0; 38.8±5.8; 29.3±5.4 mm) when compared to the right and left sides in females (38.6±3.1; 36.2±6.0; 26.9±4.5 and 38.6±3.3; 36.6±5.14; 27.7±4.6 mm) (p<0.001). Similarly, the AP length, height, and width of the SS on both sides in males (Right 26.9±6.9; 22.3±4.8; 19.3±6.4 and Left 26.4±7.6; 21.9±5.2; 19.5±6.3 mm, respectively) were significantly greater than those in females (right 23.3±6.8, 19.8±4.3, and 17.7±5.2, respectively; and left 24.3±6.7, 19.7±4.2, and 17.1±4.6 mm, respectively). We further measured the bilateral volume of FS (41 males and females, respectively), MS (40 males, 43 females), and SS (42 males, 61 females) in a subset of individuals and found that the volumes of all three paranasal sinuses were significantly greater in males than in females (p<0.001). The study also reported a low incidence of agenesis, with bilateral agenesis of the FS recorded in 1.27% of cases and unilateral agenesis in 3.78% on the right side and 0.63% on the left side. No significant age-related correlations were observed in the dimensions and volumes of the three paranasal air sinuses. Discussion One of the foremost responsibilities of forensic anthropologists is to establish a biological profile of human remains, which involves assessing and identifying characteristics such as age, gender, ancestry, and stature. 23 As the population structure changes with the influx of immigrants from diverse geographic regions, relying on population-specific data from previous groups is no longer feasible. This shift in demographics has resulted in a more diverse population, and accurate identification of individuals through physical characteristics such as ancestry, age, and gender can be challenging. 24 , 25 Thus, forensic anthropologists and other experts must stay up-to-date on the latest population trends and data to ensure that accurate identifications can be made, even for individuals from diverse backgrounds. 21 , 26 According to several studies, accurate sex determination using the skull and pelvis is a well-established practice in forensic anthropology. It has been reported that skull both and pelvis can accurately determine sex especially for adults with rates of 95% and 90% respectively. 27 , 28 This is because they are relatively imperishable owing to their challenging tissue components. 29 A study conducted by Arijit et al. 30 investigating the reliability of MS measurements obtained from CT scans and human skulls revealed that measurements of the maxillary sinus obtained from CT scans were similar to those obtained from human skulls. 31 The configuration of A study by Suman investigated FS among monozygotic twins. Their study showed that the configuration of the FS varies even among monozygotic twins, demonstrating its uniqueness and reliability for each individual. 32 Moreover, it has been shown that FS growth is completed by 18-20 years of age and seldom changes during life, except for trauma or pathology. 33 The current study showed no significant differences in FS dimensions and volume with age, possibly demonstrating that these dimensions had reached adult size. In the present study, the AP length, height, and volume of the FS showed mean values were greater in males than in females ( Figure 5 and Figure 6 ). Nutritional, hormonal, or muscular factors cause morphological differences between the sexes. 34 A CT scan study of the skulls of 53 Egyptian subjects by Motawei et al. 35 showed that the AP length, height, and width of the FS were more significant than those in our study ( Figure 7 ). Similarly, the height and width of the FS reported by Tatlisumak et al. 14 and the height, width, and volume reported by Ponde et al. 36 in a different population (Turkey and Brazil, respectively) showed relatively higher values in both sexes than in our study ( Figure 7 ). However, the FS volume in the dry skull studied by Ponde et al. 36 was significantly higher than that in our study, while Karkas et al. 37 and Fernandes et al. 38 reported FS volumes similar to our study. Various factors, such as population, genetics, and environment may play a role in these differences. 24 , 25 , 39 AP length, height, width, and volume of the MS showed that, in general, the size of the MS in our study was more extensive in males than in females ( Figure 5 and Figure 6 ). These findings were based on previous research reports wherein the size of the MS showed statistically significant values with a higher percentage of sexual dimorphism. 40 , 41 However, compared to the Zulu and European populations, the height and width of the MS were larger in the present study in both sexes. 25 Previous CT scan studies on MS also suggest that maxillary sinus height is the best discriminant parameter for sexual dimorphism. 42 Among the modern Japanese population, Kawarai et al. reported that larger MS volumes correlated with a lower prevalence of sinusitis among their people. 43 No significant changes were observed in the dimensions and volumes of the MS correlated with age in our study. However, Schatz et al. observed that the volume of the maxillary and sphenoid sinuses increased for a period up to 15 years of age, after which it remained the same. 44 Figure 7. Comparison of dimensions of Frontal sinus between the previous and current study. Likewise, the dimensions and volumes of the SS in our study did not show any significant correlation with age. However, all measurements and volumes of SS were larger in males ( Figure 5 and Figure 6 ) than in females, which is in agreement with the studies of Karakas & Kavakli and Spaeth et al. 37 , 45 However, the AP length and width of male and female SS patients in the present study were significantly lower than those reported by Spaeth et al. 45 Conclusion The dimensions and volume of paranasal air sinuses can aid in estimating the sex of an individual in forensic anthropology. Furthermore, the data obtained in this study show the importance of population-specific measurements in sex determination. CT scans can provide detailed and accurate information about anatomical features without distortion and with faster image processing time, making it a reliable technique for identifying unknown individuals, evaluating injuries, and determining the cause and manner of death. Thus, imaging is a reliable technique for identification in forensic anthropology, criminal investigations, and for documenting changes in population dynamics. In countries that do not allow autopsies for cultural or religious reasons, imaging can help evaluate possible injuries and clarify the manner and cause of death. As technology continues to advance, it is probable that imaging will play an increasingly significant role in these fields, aiding in unraveling intricate scenarios, shedding light on complex cases, and providing answers regarding human history and identity. Ethics and consent The study protocol was approved by the Manipal Academy of Higher Education through its Institutional Ethics Committee (reference number: 064 IEC 064/2010; on 09-03 2010), with participation being voluntary, anonymous, and risk-free.) in agreement with accepted international standards. Data collected were confidential and used exclusively for research purposes. Consent to participate Written informed consent was obtained to publish the CT images of the participants. Authors’ contribution Conceptualization: Soumya Vinod & Anu Vinod Ranade Data curation: Soumya Vinod & Biswabina Ray Formal analysis: Soumya Vinod & Anu Vinod Ranade Investigation: Soumya Vinod Methodology: Soumya Vinod, Anu Vinod Ranade, Rajalakshmi Rai Project administration: Soumya Vinod Resources: Soumya Vinod & Anu Vinod Ranade Supervision: Biswabina Ray Software: Soumya Vinod, Anu Vinod Ranade Validation: Soumya Vinod, Anu Vinod Ranade, Biswabina Ray Visualization: Rajalakshim Rai & Biswabina Ray Writing – original draft: Soumya Vinod, Anu Vinod Ranade Writing – review & editing: Soumya Vinod, Anu Vinod Ranade, Rajalakshmi Rai Data availability Underlying data Zenodo: Dimensions and volumes of paranasal air sinuses, https://doi.org/10.5281/zenodo.13772363 . 46 The project contains the following underlying data: • File 1: 5a-results_Tables.doc • File 2: measurements of maxillary sinus.xls • File 3: measurements of sphenoidal sinus.xls • File 4: measurements of the frontal sinus.xls • File 5: STROBE_checklist_cross-sectional (1) - Copy.docx Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). 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Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 15 Jan 2025 ADD YOUR COMMENT Comment Author details Author details 1 Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates 2 Cardiovascular Research Group, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates 3 Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangaluru, Karnataka, India 4 Department of Anatomy, AIIMS, Kalyani, West Bengal, 741245, India 5 Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates Anu Vinod Ranade Roles: Conceptualization, Formal Analysis, Methodology, Resources, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Rajalakshmi Rai Roles: Methodology, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Biswabina Ray Roles: Data Curation, Supervision, Validation, Visualization Soumya Vinod Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Resources, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 15 Jan 2025, 14:85 https://doi.org/10.12688/f1000research.156445.1 Copyright © 2025 Ranade AV et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Ranade AV, Rai R, Ray B and Vinod S. Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.12688/f1000research.156445.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 15 Jan 2025 Views 0 Cite How to cite this report: Rai SPV. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r367505 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-367505 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 28 Apr 2025 Santosh Phajir Vishwanath Rai , Department of Radiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.171759.r367505 Overall Assessment: This study presents an interesting evaluation of paranasal sinus measurements that can be applied in forensic science to estimate skeletal sex and age-at-death. The experiment provides valuable insights, but several key areas need to be addressed before ... Continue reading READ ALL Overall Assessment: This study presents an interesting evaluation of paranasal sinus measurements that can be applied in forensic science to estimate skeletal sex and age-at-death. The experiment provides valuable insights, but several key areas need to be addressed before the paper can be considered for accepting. While the strengths of the research are notable, certain minor revisions are necessary to enhance the manuscript's clarity and depth. Strengths: The study focuses on paranasal sinus morphometry for sex determination, which is highly relevant in forensic anthropology, particularly in challenging cases. The use of CT scans enhances accuracy and non-invasiveness, allowing for precise measurements of complex anatomical structures. A relatively large sample size of 158 participants increases the statistical robustness and generalizability of the findings. The measurement of sinus volume adds a unique dimension often overlooked in similar research and reporting the incidence of agenesis provides valuable information for future studies and researchers. Points for Minor Revision: Clarifying Novelty and Contribution: Some sections require minor restructuring to improve overall flow. Revise these sections to ensure logical progression of ideas. While the study contributes to existing literature, a clearer statement outlining its unique contributions is needed. I suggest the authors to add a paragraph in the discussion to highlight novel aspects and how this finding is novel compared to previous studies. Adding Brief Anatomical Context: Enhance clarity by including a brief overview of the paranasal sinus anatomy and a short section on their embryological development in the introduction. Discussing Limitations: Include a section discussing the limitations of using CT scans, such as costs and equipment accessibility, and address potential pathologies that may affect sinus measurements. Expanding Comparisons and Clinical Implications: The discussion would benefit from a deeper comparison with findings from other populations and an elaboration on clinical implications for forensic identification. Improving Data Presentation: Include a table in the results section displaying the range of measured dimensions and volumes for a comprehensive overview of the data. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: General Radiology, Cross sectional Radiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Rai SPV. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r367505 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-367505 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Nosseir N. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r375304 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-375304 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 10 Apr 2025 Nermine Nosseir , Gulf Medical University, Ajman, United Arab Emirates Approved VIEWS 0 https://doi.org/10.5256/f1000research.171759.r375304 This study examines the use of multidetector computed tomography (CT) scans in assessing sex- and age-based differences in the dimensions and volumes of frontal, maxillary, and sphenoid sinuses. The study is a retrospective cross-sectional analysis of cranial CT scans from ... Continue reading READ ALL This study examines the use of multidetector computed tomography (CT) scans in assessing sex- and age-based differences in the dimensions and volumes of frontal, maxillary, and sphenoid sinuses. The study is a retrospective cross-sectional analysis of cranial CT scans from 158 adult patients (79 males, 79 females). DICOM software was used by the researchers for the following measurements; anteroposterior length, height, width, and volume of sinuses across axial, coronal, and sagittal planes. Statistical analysis was conducted by using Pearson’s correlation and t-tests. The study showed that the sinus dimensions and volumes were significantly larger in males than females, but no significant correlation was observed with age. The findings in the study support the potential of CT-based morphometric analysis in sex determination for forensic purposes where traditional methods are limited especially in cases where fragmented remains are involved. The authors highlighted the importance of population-specific data and underscored CT imaging’s non-invasive advantage in forensic identification, particularly in regions where autopsies are restricted. The methodology of this research is clearly structured and follows the STROBE guidelines through utilizing a well-defined retrospective cross-sectional design. The sample size is balanced . High-resolution imaging with a 64-row detector CT scanner and isotropic data allowed precise, reproducible measurements across the planes. The use of DICOM software for morphometry and volumetric analysis enhances the objectivity. However, the reliance on retrospective clinical data may introduce bias of the sampling. In the present study the sinus dye injection provided volume estimation but details on validation or interobserver reliability for this step are lacking and we recommend that it should be clarified. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Gross and microscopic anatomy - Embryology- Congenital anomalies- Medical Education I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Nosseir N. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r375304 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-375304 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Samuel VP. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r375298 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-375298 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Apr 2025 Vijay Paul Samuel , Ras Al Khaimah Medical and Health Sciences University,, Ras Al Khaimah, United Arab Emirates Approved VIEWS 0 https://doi.org/10.5256/f1000research.171759.r375298 The manuscript is well written and addresses an important challenge faced by many forensic science specialist i.e to identification of people after a calamity. barring few minor spelling/grammatical errors the article can be accepted as it is. In the abstract ... Continue reading READ ALL The manuscript is well written and addresses an important challenge faced by many forensic science specialist i.e to identification of people after a calamity. barring few minor spelling/grammatical errors the article can be accepted as it is. In the abstract the word non invasive has been wrongly hyphenated. It is better to stick to the term males uniformly rather than men which has been used at some instances. Kindly clarify if reformatted is same as reformation. Need to clarify how the investigators made sure that in the CT image that was available for measurement, the section had passed at maximum ap length , width and height. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Toxicity studies ,epidemiology, anatomy and embryology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Samuel VP. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r375298 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-375298 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Casna M. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r367506 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-367506 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Feb 2025 Maia Casna , Leiden University, Leiden, The Netherlands Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.171759.r367506 This study presents an interesting evaluation of whether paranasal sinus measurements can be applied in forensic science to accurately estimate skeletal sex and age-at-death. The experiment provides valuable insights, but several key areas need to be addressed before the paper ... Continue reading READ ALL This study presents an interesting evaluation of whether paranasal sinus measurements can be applied in forensic science to accurately estimate skeletal sex and age-at-death. The experiment provides valuable insights, but several key areas need to be addressed before the paper can be considered for indexing. Major Points for Improvement: As presented in the discussion section, a substantial body of research has already explored the correlation between paranasal sinus size and skeletal sex. This is expected, given that the sinuses are part of the skull, which exhibits significant sexual dimorphism. It remains unclear how the authors' findings contribute new insights to the existing literature. I am not suggesting that these results are unimportant, but a clearer discussion is needed to highlight their novelty and significance. The manuscript does not include a section explaining the anatomy and embryology of the paranasal sinuses, which is crucial for interpreting the results. A more detailed anatomical background would also strengthen the contextualization of findings. For example, the rationale behind expecting a correlation between sinus size and age needs further clarification, given that sinus development is largely complete by the time an individual reaches adult age. Without a clearer explanation, it is difficult to understand the relevance and utility of this analysis. As a general reccomendation, the manuscript would benefit from careful proofreading, as there are multiple spelling errors and instances of repeated sentences. Please ensure that all inconsistencies are addressed before resubmission. In addition, the introduction and discussion sections should be restructured for clarity. Some topics (e.g., the presence of foreign bodies in the sinuses, human migration) are mentioned without a clear link to the main research question or analysis. These connections should be explicitly explained. Finally, I am sure that, with further refinement, this paper could make a valuable contribution to forensic literature on the paranasal sinuses. I strongly encourage the authors to revise and resubmit after addressing these critical points. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Bioarchaeology, anatomy and embryology of the paranasal sinuses. I suggest reaching out to a forensic professional for further comments on the contribution these data give to forensic science. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Casna M. Reviewer Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r367506 ) The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-367506 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 15 Jan 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 1 15 Jan 25 read read read read Maia Casna , Leiden University, Leiden, The Netherlands Vijay Paul Samuel , Ras Al Khaimah Medical and Health Sciences University,, Ras Al Khaimah, United Arab Emirates Nermine Nosseir , Gulf Medical University, Ajman, United Arab Emirates Santosh Phajir Vishwanath Rai , Manipal Academy of Higher Education, Manipal, India Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Rai S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 28 Apr 2025 | for Version 1 Santosh Phajir Vishwanath Rai , Department of Radiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India 0 Views copyright © 2025 Rai S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Overall Assessment: This study presents an interesting evaluation of paranasal sinus measurements that can be applied in forensic science to estimate skeletal sex and age-at-death. The experiment provides valuable insights, but several key areas need to be addressed before the paper can be considered for accepting. While the strengths of the research are notable, certain minor revisions are necessary to enhance the manuscript's clarity and depth. Strengths: The study focuses on paranasal sinus morphometry for sex determination, which is highly relevant in forensic anthropology, particularly in challenging cases. The use of CT scans enhances accuracy and non-invasiveness, allowing for precise measurements of complex anatomical structures. A relatively large sample size of 158 participants increases the statistical robustness and generalizability of the findings. The measurement of sinus volume adds a unique dimension often overlooked in similar research and reporting the incidence of agenesis provides valuable information for future studies and researchers. Points for Minor Revision: Clarifying Novelty and Contribution: Some sections require minor restructuring to improve overall flow. Revise these sections to ensure logical progression of ideas. While the study contributes to existing literature, a clearer statement outlining its unique contributions is needed. I suggest the authors to add a paragraph in the discussion to highlight novel aspects and how this finding is novel compared to previous studies. Adding Brief Anatomical Context: Enhance clarity by including a brief overview of the paranasal sinus anatomy and a short section on their embryological development in the introduction. Discussing Limitations: Include a section discussing the limitations of using CT scans, such as costs and equipment accessibility, and address potential pathologies that may affect sinus measurements. Expanding Comparisons and Clinical Implications: The discussion would benefit from a deeper comparison with findings from other populations and an elaboration on clinical implications for forensic identification. Improving Data Presentation: Include a table in the results section displaying the range of measured dimensions and volumes for a comprehensive overview of the data. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise General Radiology, Cross sectional Radiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Rai SPV. Peer Review Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r367505) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-367505 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Nosseir N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 10 Apr 2025 | for Version 1 Nermine Nosseir , Gulf Medical University, Ajman, United Arab Emirates 0 Views copyright © 2025 Nosseir N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This study examines the use of multidetector computed tomography (CT) scans in assessing sex- and age-based differences in the dimensions and volumes of frontal, maxillary, and sphenoid sinuses. The study is a retrospective cross-sectional analysis of cranial CT scans from 158 adult patients (79 males, 79 females). DICOM software was used by the researchers for the following measurements; anteroposterior length, height, width, and volume of sinuses across axial, coronal, and sagittal planes. Statistical analysis was conducted by using Pearson’s correlation and t-tests. The study showed that the sinus dimensions and volumes were significantly larger in males than females, but no significant correlation was observed with age. The findings in the study support the potential of CT-based morphometric analysis in sex determination for forensic purposes where traditional methods are limited especially in cases where fragmented remains are involved. The authors highlighted the importance of population-specific data and underscored CT imaging’s non-invasive advantage in forensic identification, particularly in regions where autopsies are restricted. The methodology of this research is clearly structured and follows the STROBE guidelines through utilizing a well-defined retrospective cross-sectional design. The sample size is balanced . High-resolution imaging with a 64-row detector CT scanner and isotropic data allowed precise, reproducible measurements across the planes. The use of DICOM software for morphometry and volumetric analysis enhances the objectivity. However, the reliance on retrospective clinical data may introduce bias of the sampling. In the present study the sinus dye injection provided volume estimation but details on validation or interobserver reliability for this step are lacking and we recommend that it should be clarified. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Gross and microscopic anatomy - Embryology- Congenital anomalies- Medical Education I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Nosseir N. Peer Review Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r375304) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-375304 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Samuel V. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Apr 2025 | for Version 1 Vijay Paul Samuel , Ras Al Khaimah Medical and Health Sciences University,, Ras Al Khaimah, United Arab Emirates 0 Views copyright © 2025 Samuel V. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The manuscript is well written and addresses an important challenge faced by many forensic science specialist i.e to identification of people after a calamity. barring few minor spelling/grammatical errors the article can be accepted as it is. In the abstract the word non invasive has been wrongly hyphenated. It is better to stick to the term males uniformly rather than men which has been used at some instances. Kindly clarify if reformatted is same as reformation. Need to clarify how the investigators made sure that in the CT image that was available for measurement, the section had passed at maximum ap length , width and height. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Toxicity studies ,epidemiology, anatomy and embryology. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Samuel VP. Peer Review Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r375298) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-375298 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Casna M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Feb 2025 | for Version 1 Maia Casna , Leiden University, Leiden, The Netherlands 0 Views copyright © 2025 Casna M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This study presents an interesting evaluation of whether paranasal sinus measurements can be applied in forensic science to accurately estimate skeletal sex and age-at-death. The experiment provides valuable insights, but several key areas need to be addressed before the paper can be considered for indexing. Major Points for Improvement: As presented in the discussion section, a substantial body of research has already explored the correlation between paranasal sinus size and skeletal sex. This is expected, given that the sinuses are part of the skull, which exhibits significant sexual dimorphism. It remains unclear how the authors' findings contribute new insights to the existing literature. I am not suggesting that these results are unimportant, but a clearer discussion is needed to highlight their novelty and significance. The manuscript does not include a section explaining the anatomy and embryology of the paranasal sinuses, which is crucial for interpreting the results. A more detailed anatomical background would also strengthen the contextualization of findings. For example, the rationale behind expecting a correlation between sinus size and age needs further clarification, given that sinus development is largely complete by the time an individual reaches adult age. Without a clearer explanation, it is difficult to understand the relevance and utility of this analysis. As a general reccomendation, the manuscript would benefit from careful proofreading, as there are multiple spelling errors and instances of repeated sentences. Please ensure that all inconsistencies are addressed before resubmission. In addition, the introduction and discussion sections should be restructured for clarity. Some topics (e.g., the presence of foreign bodies in the sinuses, human migration) are mentioned without a clear link to the main research question or analysis. These connections should be explicitly explained. Finally, I am sure that, with further refinement, this paper could make a valuable contribution to forensic literature on the paranasal sinuses. I strongly encourage the authors to revise and resubmit after addressing these critical points. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? No If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Bioarchaeology, anatomy and embryology of the paranasal sinuses. I suggest reaching out to a forensic professional for further comments on the contribution these data give to forensic science. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Casna M. Peer Review Report For: Beyond the Surface: A Multidetector Computer Tomography Scan Investigation into Age and Gender Differences. [version 1; peer review: 2 approved, 1 approved with reservations, 1 not approved] . F1000Research 2025, 14 :85 ( https://doi.org/10.5256/f1000research.171759.r367506) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-85/v1#referee-response-367506 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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