RESUMEN
The anatomical uniqueness of the frontal sinus morphology has been widely used for comparative forensic identification using various techniques, mostly including 2D X-rays or one fixed slice of an axial computed tomography (CT) scan image. However, computer-aided 3D automatic graphical comparison techniques can provide accurate comparisons between two 3D models that allow users to comply with even the strictest deviation standards, avoiding error-prone identification of frontal sinuses with similar morphologies. The study proposes the use of a computer-aided comparative paradigm based on the 3D-3D frontal sinus model superimposition process and further assesses the anatomical uniqueness of frontal sinuses using a large Chinese Han sample. Three hundred thirty-six patients older than 20 years with two multi-slice CT scans were collected. Frontal sinus 3D models were semi-automatically segmented through Dolphin Imaging software. Automatic pairwise comparisons of 336 matched pairs from the same person and 340 mismatched pairs from different individuals with an analysis of average root mean square (RMS) point-to-point distance were performed using Geomagic Studio Qualify software. RMS ranged between 0.005 and 1.032 (mean RMS 0.390 ± 0.25 mm) in the group of matches and between 1.107 and 19.363 (mean RMS 4.49 ± 2.69 mm) in the group of mismatches. On average, the RMS value was over ten-fold greater in mismatches than in matches. Statistically significant differences in RMS between the group of matches and mismatches were assessed using the Mann-Whitney U test (p < 0.05). This study supports the value of the frontal sinus with a 3D computer-aided superimposition method for human identification with large samples when DNA, fingerprints, and dental materials are not accessible.