Nergis Canturk

Determination of gender by measuring the size of the maxillary sinuses in computerized tomography scans

BackgroundIdentification of corpses is a difficult forensic procedure and it is mandated by laws and social rules. Comparison of ante mortem and post-mortem medical records, such as dental documents, plays an important role in the identification of corpses. However, typical identification methods may be inconclusive, especially when certain extreme post-mortem changes have developed. Gender has long been determined from the skull, the pelvis and the long bones with an epiphysis and a metaphysis in unknown skeletons. The aim of this study was to investigate whether the width, the length and the height of the maxillary sinuses could be used for determination of gender.Materials and MethodsThe width, the length and the height of the maxillary sinuses were measured in 127 adult patients who were admitted to the Department of Radiology for computed tomography scans of their sinuses. Of 127 patients, 62 (48.8%) were females and 65 (51.2%) were males. The width, the length and the height of the maxillary sinuses were measured in Computerized Tomography scans (Hitachi Radix Turbo computed tomography) when the patients were in prone position without sedation or contrast medium. The data were subjected to a discriminative analysis using the SPSS package program (Version 11.5).ResultsThe discriminative analysis showed that the accuracy of maxillary sinus measurements—i.e. the ability of the maxillary sinus size to identify gender—was 69.4% in females and 69.2% in males.ConclusionComputerized Tomography measurements of maxillary sinuses may be useful to support gender determination in forensic medicine; however, with a relatively low-accuracy rate (less than 70%).

Age determination from central incisors of fetuses and infants.

Age at time of death for a fetus or infant is an important issue in the field of forensic science. Dental development can give an accurate measure of infant and fetal age and current literature does not include any studies of dental age from central incisor development. The objective of this study is to determine the age of deceased fetuses and infants by examining metric tooth development of central incisors in deceased fetuses and infants. Five dimensions of 76 maxillary and mandibular central incisors were measured: mesio-distal (MD), bucco-lingual (BL), crown height (CH), crown thickness (CT), and root height (RH). The results showed that 44.45+/-0-2 weeks is a sectional time for age calculations, which corresponds to 40 weeks from conception plus 4 to 5 weeks after birth. Four ATA entitled age formulas are derived to give the relation of age with tooth dimensions before and after 44.45 weeks [ATA is the special name given to the honor of the great Turkish leader Mustafa Kemal Atatürk (1881-1938)]. Age estimation can be calculated from these formulas with an accuracy of the age +/-0-2 weeks. Also, calcification time can be determined from ATA formulas. In conclusion, the age of fetuses and infants can be assessed by the measurements of a single central incisor. According to this research, when estimating age during identification studies, forensic researchers must take into consideration the period of embryonic human growth and development.

Characterization of the Anatomic Location of the Pituitary Stalk and Its Relationship to the Dorsum Sellae, Tuberculum Sellae and Chiasmatic Cistern

OBJECTIVE The normal anatomic relationships characteristic of the pituitary stalk area were previously thought to involve only one location. The purpose of this study was to re-evaluate the anatomic location of the pituitary stalk and possible varying locations in relation to the tuberculum sellae and dorsum sellae using morphometric evaluation and anatomic dissection of human cadaveric specimens. The surgical implications of the variations are discussed. METHODS The calvaria were removed via routine autopsy dissections, and the brains were removed from the skull while preserving the pituitary stalk. The diaphragma sellae, tuberculum sellae, and the location of the pituitary stalk were examined in 60 human cadaveric heads obtained from fresh adult cadavers. Empty sellae were excluded. RESULTS The openings of the diaphragma sellae averaged 6.62 +/- 1.606 mm (range, 3-9 mm). The distance between the tuberculum sellae and the posterior part of the pituitary stalk was 1 to 8 mm. The upper face of the diaphragma sellae appeared flat in 26 (43%), concave in 24 (40%), and convex in 6 cases (10%), with a prominent tuberculum sellae in 4 cases (7%). The location of the chiasm was normal in 47 cases (78%), with a prefixed chiasm in 3 cases (5%) and a postfixed chiasm (17%) in the 10 cases. Four cadaver specimens had prominent tuberculum sellae and other parameters were not evaluated. CONCLUSION When opening the chiasmatic cistern, neurosurgeons should be aware about the relationship between the pituitary stalk and the surrounding structures to prevent inadvertent injury to the pituitary stalk.

Autopsy findings of suicidal deaths committed by firearms in Ankara, Turkey

The purpose of this study was to examine autopsy findings from suicidal deaths using firearms in Ankara, Turkey, and to compare the results with those reported from other studies. We retrospectively evaluated suicidal deaths by firearms referred for autopsy to the Morgue Department, Institute of Forensic Medicine, between 2002 and 2004. Results were subjected to discriminant analyses using SPSS 11.5 package program. One hundred and fifteen cases (83.3%) were male, the ratio of male to female was 5 to 1 and the mean age was 31.96 years (range:12-85 years). Forty cases were aged between 12 years and 20 years, 28 were aged between 0 and 18 (20.29%). One hundred and thirty-three cases (96.4%) had one bullet entry and five cases (3.6%) had two bullet entries. Out of 143 bullet entries, 116 (81.12%) were caused by gunshots fired from contact or near contact range. Regarding bullet entry sites, 103 (72.03%) were on the head with 56 (54.37%) located on the right temporal region. Gunshot related crimes are an increasing cause for concern in Turkey. However, a simple preventive measure may prevent the suicidal deaths of many young people.

Medico‐legal child deaths in Istanbul: data from the Morgue Department

Background: Before determining health policies, finding solutions to problems and taking precautions, one should define the problems and their regional and national dimensions. Data about causes of death vary from country to country and, therefore, it is clear that precautions should be based on regional data and needs, which will be more effective.

Critical course of the anterior laryngeal branch of the inferior laryngeal nerve

Background:  Although in the past few authors stated that the nerve penetrated the ligament of Berry, many new authors have not confirmed this assertion. Because of the clinical importance and indefiniteness of this subject, we aimed to present an anatomical study concerning the course of the inferior laryngeal nerve.

Neonatal line on fetus and infant teeth: An indicator of live birth and mode of delivery.

BACKGROUND The neonatal line (NL) is an important issue in forensic odontology. It is the sign of a developmental birth defect, which is caused by the effect of metabolic stress on tooth structures when the fetus passes to extrauterine life. AIMS The aim of this research is to determine the existence and thickness of NL in teeth, as it is a legal necessity to indicate the signs of viability at birth in a forensic examination of a fetus or infant case. STUDY DESIGN AND SUBJECTS This research was conducted on 48 lower left and right lateral teeth, which were taken from 24 autopsy cases (46% female and 54% male). Left lateral teeth were sectioned in a vertical plane and right lateral teeth were sectioned in a horizontal plane. The NL thickness was measured with a scanning electron microscope (SEM). These cases comprised three conditions as: 70.3% normal birth, 16.7% caesarean sections, and 12.5% still birth cases under the legal and ethical permission. OUTCOME MEASURES The mean NL thickness of normal birth cases was higher than caesarean cases as 7.7μm and 2.5μm, respectively. RESULTS AND CONCLUSIONS The results showed a statistical significance between all birth conditions. NL does not exist in still birth cases (p<0.001). Not only is the presence of NL a sign of live birth, but also its thickness is an indicator of the delivery mode where NL thickness of normal birth was found thicker than the caesarean cases.

Anatomic relationship between the anterior sylvian point and the pars triangularis

The aim of this study was to show morphological sulcal variations of the pars triangularis of the inferior frontal gyrus and to provide a clearer description of the anterior sylvian point. Thirty‐six hemispheres of 18 adult cadavers were studied. The hemispheres were harvested by the classical autopsy method and fixed in 10% formalin solution for three weeks. In six hemispheres, the arteries and veins were filled with colored silicone. The proximal and distal segments of the sylvian fissure, the perpendicular distance of both the anterior sylvian point and inferior rolandic point to the insular cortex and the distances between the anterior ascending ramus and the precentral, central, and postcentral sulcus were measured. The anterior horizontal and ascending rami were exposed. The sulcus located on the pars triangularis was appraised. The relationship between the anterior sylvian point and the vascular structure around the sylvian fissure was examined. The rising of the anterior horizontal and ascending ramus from the sylvian fissure defines the shape of the pars triangularis. The pars triangularis has three shapes: V, U, and Y. In V‐ and Y‐shaped pars triangularis both rami merge but in U‐shaped pars triangularis the rami do not merge. The pars triangularis was Y‐shaped in 30.76% (4/13) of the right hemispheres and in 50% (7/14) of the left hemispheres; U‐shaped in 20.3% (3/13) of the right hemispheres and in 35.71% (5/14) of the left hemispheres; V‐shaped in 40.61% (6/13) of the right hemispheres and in 14.29% (2/14) of the left hemispheres. Minimally invasive procedures use basic anatomic landmarks intracranially to reach the targeted area; therefore, exact and detailed knowledge of the anatomy of the sylvian fissure and pars triangularis is of great importance. Clin. Anat. 25:429–436, 2012.

Evaluation of forensic perinatal and neonatal autopsies in Istanbul

ObjectiveAutopsy findings play an important role in prevention of perinatal and neonatal deaths. Therefore, we attempted to reveal demographic and forensic features of these deaths in Turkey.MethodsWe retrospectively reviewed autopsy reports for 184 cases of perinatal deaths released from Istanbul Forensic Medicine Institute Morgue between 2000 and 2002 and investigated demographic and medico-legal features of the cases.ResultsThe mean age of the cases was 2.98 ± 6.41 days. Fifteen point two percent (15.2 2%) of the cases were of murder, 52.7% of the cases were illegitimate children and 41.3% had the ability to survive.ConclusionIt can be suggested that autopsy and post-mortem examinations should be performed in order to determine the real causes and contributing factors of perinatal and neonatal deaths. Data obtained in autopsies and postmortem examinations will make great contributions to the prevention of these deaths.

Age estimation from primary teeth through virtual dental identification

Dental identification from tooth structures can offer a major contribution to forensic science in oral autopsy procedures. Recently, digital virtual examinations have been preferred instead of traditional operations. The aim of this research is to estimate the chronological age from primary teeth using computerised tomography images and to determine the best measurement from the axes of these images. This study was conducted on the dental images of 28 patients of known age (1–195 weeks) using the central teeth measurements that can be displayed on the two image axes. The results show that virtual dental identification from computerised tomography images is a reliable method. The best measurements for age estimation can be obtained from the longest vertical dimension in the sagittal plane, which is the tooth height (R2 =  96.4). Additionally, the best age estimation formula was generated from the tooth height with labio-lingual measurement (R2 = 98.1), where the margin of error of the mean predicted value was equal to ± 1.07 weeks. This age estimation formula can be applied up to two years of age, which is the completion of upper central primary tooth development. In conclusion, virtual dental identification procedures can be applied in cases of forensic odontology investigations.