Evaluation of sexual dimorphism in the foramina of the middle cranial fossa using high-resolution multi-slice computed tomography scan: A cross-sectional study

• Published in: Journal of forensic and legal medicine Vol. 115; p. 102935
• Main Authors: Sharif, Asmaa F., El-Sarnagawy, Ghada N., Reda, Alaa Mohamed, Ghonem, Mona M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2025
• Subjects: Computed tomography; Cranial fossa; Foramen ovale; Foramen rotundum; Foramen spinosum; Forensic anthropology; Pathology; Foramen spinosum; Forensic anthropology; Foramen ovale; Computed tomography; Cranial fossa; Foramen rotundum
• ISSN: 1752-928X; 1878-7487; 1878-7487
• DOI: 10.1016/j.jflm.2025.102935

Sex estimation is a primary concern in forensic medicine. Although few studies have investigated sexual dimorphism in the middle cranial fossa, the obtained findings are still inconsistent. A cross-sectional study was conducted to investigate the sexual dimorphism in three foramina [foramen ovale, foramen rotundum, and foramen spinosum] using a high-resolution 128 multi-slice three-dimensional (3D) computerized tomography scanner. Two hundred and forty adult Egyptians (55.4 % females and 44.6 % males) were included with a female: male ratio 1.2 and a mean age of 42. 87 (10.82) years. All investigated cases were industrial and agricultural workers with no history of traumatic or pathological conditions affecting their middle cranial fossa. The obtained measurements were significantly greater on the left side. The Egyptian males displayed significantly higher anteroposterior dimensions of the foramen ovale, as well as the distance between the midline and the left foramen ovale (p < 0.001)/the right foramen spinosum (p = 0.018). A proposed model for predicting sex exhibited a high area under the curve (0.819), a sensitivity of 80.37 %, and a specificity of 70.68 %. Furthermore, a substantial correlation was found between the actual and predicted probabilities, indicating good calibration. This study offers an excellent non-invasive alternative to other unavailable skeletal measurements for estimating sex among Egyptian populations, filling a critical gap in forensic anthropology. Obtaining such objective morphometric measurements also contributes to safe clinical practice in diagnosis and treatment in various surgical fields, emphasizing the importance of anatomical variations in the context of sex differences. •The foramen ovale, foramen rotundum, and foramen spinosum are larger on the left side.•Males display higher anteroposterior dimensions of foramen ovale than females.•Males have greater distance between the left foramen ovale and the midline.•Males have greater distance between the right foramen spinosum and the midline.•The proposed sex estimating model shows high AUC (0.819), and a sensitivity of 80.37 %.