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open access eISSN 2093-3673

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Original Article

Anat Cell Biol 2022; 55(3): 294-303

Published online September 30, 2022


Copyright © Korean Association of ANATOMISTS.

Distribution of frontal sinus pattern amongst Malaysian population: a skull radiograph study

Nur Damia Iwani Zulkiflee1 , Mansharan Kaur Chainchel Singh2,3 , Aspalilah Alias4,5,6 , Helmi Mohd Hadi Pritam7 , Eric Chung8 , Rani Sakaran9 , Nurul Hannim Zaidun1 , Choy Ker Woon1

1Department of Anatomy, Faculty of Medicine, Universiti Teknologi MARA, Selangor, 2Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Universiti Teknologi MARA, Selangor, 3Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, 4Department of Basic Sciences and Oral Biology, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia, 5Forensic Odontology Unit, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium, 6Department of Forensic Odontology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia, 7Forensic Unit, School of Health Sciences, Universiti Sains Malaysia, Kelantan, 8Department of Biomedical Imaging, University Malaya Medical Centre, Kuala Lumpur, 9Department of Anatomy, Asian Institute of Medicine, Science and Technology (AIMST), Kedah, Malaysia

Correspondence to:Choy Ker Woon
Department of Anatomy, Faculty of Medicine, Universiti Teknologi MARA, Selangor 47000, Malaysia
E-mail: choykerwoon@uitm.edu.my

Received: April 7, 2022; Revised: May 11, 2022; Accepted: May 27, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Frontal sinus has unique anatomical features that are distinct to every population. However, the distribution of frontal sinus patterns has yet to be explored in the Malaysian population. This study aimed to describe the distribution of frontal sinus patterns among adult Malaysians. 409 adult Malaysian posteroanterior skull radiographs, consisting of 200 males and 209 females of Malay, Chinese, and Indian races aged between 20–69 years old, were included in the study. The frontal sinus patterns were classified according to total and percentage of presence or absence of frontal sinus, symmetry or asymmetrical (right or left dominant), unilateral absence (right or left), bilateral absence, and lobulation. The findings showed that bilateral presence of frontal sinus is common, in 95.4% of individuals and bilateral absence was noted in 2.7% individuals. Unilateral absence was found in 2.0% of individuals. Asymmetrical frontal sinus was observed in 54.5% of population meanwhile 40.8% showed symmetrical frontal sinus. The majority of individuals, regardless of sex, race, and age, possessed 1 to 3 lobes on both sides of the frontal sinus. The findings suggest that the frontal sinus is highly asymmetric, and the absence of the frontal sinus is rare. This morphological variation provides an insight into the landmarking placement for measurement during forensic application and assists neurosurgeons in surgical procedure to avoid breaching of the frontal sinus.

Keywords: Forensic anthropology, Frontal sinus, Malaysian, Radiograph

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