Potential role of the sella turcica X-ray imaging aspects for sex estimation in the field of forensic anthropology: a systematic review and meta-analysis.

Several studies have evaluated the parameters of normality of the sella turcica (ST), which is important to face different craniofacial syndromes that may affect this structure. Therefore, this research summarized the scientific evidence on the role of ST in the sex estimation of non-syndromic individuals. The research protocol was registered (Prospective International Registry of Systematic Reviews # CRD42021256469), followed by an electronic search in six databases (PubMed, LILACS, Web of Science, Scopus, EMBASE, and LIVIVO) and gray literature (Google Scholar and OpenGrey). Meta-analysis of linear (width, length, height, and diameter) and volumetric measurements, in addition to an assessment of risk of bias (RoB) and certainty of evidence, were performed. After the screening of 986 articles, 13 were evaluated by meta-analysis (1 307 males and 1 231 females). In subgroup analysis, females had lower values for width (lateral radiograph; -0.67 mm; P = 0.040), length (computed tomography; -0.23 mm; P = 0.020), and diameter (computed tomography; -0.27 mm; P < 0.001) compared to males. There was no statistically significant difference regarding height (P = 0.95), area (P = 0.72), and volume (P = 0.21). Most studies exhibited moderate RoB, and the certainty of evidence of the outcomes was very low. In this review, significant differences were observed between the sexes for the length and diameter of the ST; however, the heterogeneity of the studies must be considered. Key points: Studies from different geographic regions evaluated the morphology of ST according to sex and showed this anatomical structure as an important indicator of dimorphism.Meta-analysis showed shorter ST length and diameter in women.Subgroup analysis found lower ST width in women based on lateral skull radiographs.Subgroup analysis found smaller lengths and diameters in women based on CT scans.

Diagnostic accuracy of paranasal sinus measurements on multislice computed tomography for sex estimation: A systematic review, meta-analysis, and meta-regression.

This systematic review aimed to answer the question, "Are paranasal measurements obtained with multislice computed tomography able to accurately estimate sex?" This PROSPERO-registered systematic review included six databases and gray literature. Meta-analysis of linear and volumetric data was performed using a random-effects model, mean differences (MDs), and inverse variance. The QUADAS-2 tool-related risk of bias (RoB) and certainty evidence (GRADE approach) were assessed. A total of 1651 articles were initially selected from the main electronic databases for title and abstract screening. After removing duplicates and studies that did not meet the inclusion criteria, 18 studies were eligible for the meta-analysis. The screened studies included 2507 computed tomography of non-pathologic paranasal sinuses of adults aged between 18 and 40 years. Frontal sinus (FS) width (-4.89 mm; p < 0.00001) and maxillary sinus (MS) height (-3.73 mm; p < 0.00001) showed the greatest MD between females and males. Regarding volume, the MD was significant (p < 0.00001) in both paranasal sinuses (-3.01 and -1.04 cm3 , respectively). The best sensitivity (ability to identify males) and specificity (ability to identify females) were found for the anteroposterior (72.3%) and intermaxillary (69%) MS distances, respectively. In general, all studies exhibited low RoB and applicability concerns. The certainty of the evidence was categorized as very low to moderate. Both paranasal sinuses were shown to be dimorphic structures, which could be valuable tools for forensic identification using the FS width and MS anteroposterior distance measurements. However, heterogeneity among studies must be considered.

Tratamento cirúrgico de fratura orbitária blow-out pura com tela de titânio: relato de caso clínico / Surgical treatment for blow-out pure orbital fracture using titanium mesh: clinical case report

As fraturas orbitárias do tipo blow-out são classificadas em dois tipos: pura e impura. O seu diagnóstico é realizado através do exame clínico auxiliado por exames de imagens. Dentre todas as imagens, a mais indicada é a tomografia computadorizada que oferece uma melhor visualização e avaliação do traço de fratura e possibilita um melhor planejamento cirúrgico.O tipo do tratamento, cirúrgico ou não-cirúrgico, assim como o momento mais oportuno para esse tratamento das fraturas orbitárias blow-out, imediato ou tardio, é controverso na literatura. O objetivo deste trabalho é apresentar um caso clínico de fratura orbitária blow-out pura, tratado cirurgicamente e de forma imediata com sucesso clínico.

Fractures orbital blow-out are ranked in two types: pure and impure. Diagnosis is made through clinical examination aided by images. Among these images, the most recommended is CT, which provides better visualization and evaluation of the fracture and also allows better surgical planning. The treatment type, surgical or not, as well as timing, immediate or late on, of treatment for orbital blow-out fractures is controversial in the literature. The objective of this paper is to present a pure blow out fracture case surgically treated and immediately after.