Morphologic and Morphometric Analysis of Crista Galli for Gender Determination using Cone Beam Computed Tomography: A Cross-sectional Study

Introduction: Gender determination is a key process in forensic investigations. The Crista Galli (CG) is a significant anatomical structure of the skull and a crucial endoscopic landmark in pituitary surgeries and the frontal sinus approach. A few studies have reported a certain degree of sexual dimorphism in the morphology of the CG. Considering the scarcity of studies in which the CG and adjacent structures were analysed using Cone Beam Computed Tomography (CBCT), especially in the Indian population, a need was felt to conduct this study. Aim: To analyse the morphologic and morphometric characteristics of the CG and its application for gender determination using CBCT. Materials and Methods: The present cross-sectional study was conducted in the Department of Oral Medicine and Radiology at Dr. D. Y. Patil College and Hospital, Pimpri, Pune, Maharashtra, India, over a period of six months from April 2024 to October 2024. A total of 228 CBCT scans, 114 for each gender, were retrospectively analysed by two independent observers using Image Comparison Analysis Tool (i-CAT) software version 1.9.3.14. The height, width, length, and shape of the CG, as well as the presence of pneumatisation, were assessed. Kero’s classification was used for morphological categorisation. Descriptive and inferential statistics, unpaired t-tests, and Chi-square tests were performed for statistical analysis. The Cronbach alpha test was used to measure inter-examiner reliability. Results: Out of the 228 participant scans, the mean±SD of the length of the CG in males was 11.17±2.14 mm, whilst in females it was 11.45±2.19 mm. The mean±SD of the width of the CG in males was 4.72±1.66 mm, whereas in females it was found to be 5.08±1.35 mm. The mean±SD of the height of the CG in males was 13.08±2.88 mm and in females it was 13.32±2.52 mm. A statistically significant difference (p-value=0.049) in the width of the CG was observed between the two genders. A significant association was found between Kero’s classification and gender, but not between pneumatisation and gender. The Cronbach alpha score of 0.911 was indicative of good inter-examiner reliability. Conclusion: This study suggests that the CG could serve as a potential indicator for gender determination. Additionally, since the CG shows morphological variation, its meticulous examination before any interventional procedure in the anatomical region is essential.