IJCRR

IJCRR - 4(20), October, 2012

Pages: 127-133

Date of Publication: 20-Oct-2012

DETERMINATION OF AGE BY STUDY OF SKULL SUTURES

Author: Pragnesh Parmar, Gunvanti B. Rathod

Category: Healthcare

Abstract:Objectives: The objectives of this study are to determine the age by study of skull sutures and comparing the age with standard data mentioned in different textbooks and previous studies. Material and Method: Present study based on closure of skull sutures among 220 cases between age group of 15 - 70 years with age interval of 5 years and 20 cases from each age group were studied, who were exposed to digital X-ray of skull for closure of suture ecto-cranially for age estimation. The closure of sagittal, coronal, lambdoid, parieto-mastoid, parieto-temporal (squamous) and baso-occiput with baso-sphenoid sutures were studied and compared with standard data mentioned in different textbooks and previous studies. Age of each individual studied was confirmed from birth certificate, service record, driving license, passport, ration card or voter's card. Result: Each suture was found to close at particular age group. Suture closure occurred for sagittal, lambdoid, coronal, parieto-mastoid, parieto-temporal and baso-occiput with baso-sphenoid at age group of 50-60 years, 45-55 years, 50-60 years, 55-70 years, 60-70 years and 18-25 years respectively. Conclusion: Age of closure of sagittal, coronal, lambdoid, parieto-mastoid, parieto-temporal and baso-occiput with baso-sphenoid suture was matching with standard data given in most of the textbooks and other studies. Sutures closure occurred from their endo-cranial to ecto-cranial aspects. Closure of skull sutures occurred earlier in male than in females. The most successful estimate was done from sagittal suture, next lambdoid suture and then coronal suture.

Keywords: Skull sutures, Age estimation, Sagittal suture, Coronal suture, Lambdoid suture.

Full Text:

INTRODUCTION
Age estimation, either in living, dead or human remains, is a complex problem in medical justice in both civil and criminal matters such as identification, senior citizen concession, retirement benefits, competency as witness, attainment of majority, marriage, impotency, sterility, consent, juvenile offender, kidnapping, rape etc. In general, age estimation is done by team of forensic expert and radiologist. If proper opinion regarding the age is not given then injustice may occur to the patient. Age estimation by means of closure of skull sutures is a very important tool to solve above mentioned cases. [1] Age determination is a very difficult task as the age advances, with conventional methods. In adulthood and old age, opinion is given in the form of age range instead of any particular age. As the age advances, this range becomes wide. In order to decrease this wide age range, combined study of physical examination along with closure of skull sutures should be done. Other factors also affect the age like nutritional, hereditary, racial, endocrine etc. Epiphyses of bones unite and sutures of skull close at a particular age for a given population. Determination of age from skull sutures has great medico legal importance as it is the most reliable evidence for estimating the age of person. [2]

MATERIAL AND METHODS
In this study, 220 cases (male and female both), between age group of 15 - 70 years with age interval of 5 years and 20 cases from each age group were studied who were exposed to digital X-ray of skull both antero-posterior and lateral view for closure of suture ecto-cranially. Age of each individual studied was confirmed from birth certificate, service record, driving license, passport, ration card or voter’s card and compared with radiological findings for accuracy. In this study, we considered only complete union of the sagittal, coronal, lambdoid, parieto-mastoid, parieto-temporal (squamous) and baso-occiput with baso-sphenoid sutures instead of taking into account other scoring system of suture closure and compared with standard data mentioned in different text books and previous studies.

OBSERVATION
In our study, age of earliest union for sagittal, lambdoid, coronal, parieto-mastoid, parietotemporal and baso-occiput with baso-sphenoid suture was 46 years, 38 years, 46 years, 43 years, 54 years and 17 years respectively and age group for sagittal, lambdoid, coronal, parieto-mastoid, parieto-temporal and baso-occiput with basosphenoid suture was 50-60 years, 45-55 years, 50- 60 years, 55-70 years, 60-70 years and 18-25 years respectively as per Table – 1. Different sutures closure in different age groups were given in Table – 2. Comparison of time of closure of sagittal suture was given in Table – 3. [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13] Comparison of time of closure of lambdoid suture was given in Table – 4. [1, 2, 3, 4, 5, 6, 8, 14, 15] Comparison of time of closure of coronal suture was given in Table – 5. [1, 2, 3, 4, 5, 6, 7, 8, 14, 15, 16] Comparison of time of closure of parieto-mastoid suture was given in Table – 6. [1, 2, 6, 14, 15] Comparison of time of closure of parieto-temporal (squamous) suture was given in Table – 7. [1, 2, 3, 4, 7, 14, 15] Comparison of time of closure of baso-occiput with baso-spheoid suture was given in Table – 8. [2, 3, 4, 5, 6, 7, 8, 17, 18]

DISCUSSION
Identification means determination of individuality of a person. Study of closure of skull sutures is a very important tool for age estimation in adult. The most commonly studied aspect of cranial sutures is the degree of their obliterations as an indicator of age. Suture closure scoring system as per Buikstra and Ubelaker [19] was given in Table – 9. Meindl and Lovejoy scoring system (1985) [20] was given in Table – 10. Acsadi and Nemeskeri scoring system (1970) [21] and Perizonius (1984) [22] scoring system was given in Table – 11. In our study, we considered only complete union of sutures instead of taking into account other scoring system of suture closure. Observations of cranial suture closure were first observed as far back as the 1st century in the work of Hippocrates, but were not utilized as an ‘identification tool’ with relation to age until a much later date. [11, 12, 13] Vesalius and his pupil Fallopius were credited for the first noting the apparent progression of suture obliteration with age in 1542. [11, 12, 23, 24, 25, 26] Despite some early descriptions of the variability of cranial suture closure, scientific studies addressing its relationship with age have been published in great number from the 19th century to present [10]. This continued popularity has survived not due to its validity but rather the idea that, if it has been studied for so long, surely there has to be something to it, and thus it becomes a traditional research obsession. [26]

CONCLUSION
Age of closure of sagittal, coronal, lambdoid, parieto-mastoid, parieto-temporal and basoocciput with baso-sphenoid suture was matching with standard data given in most of the textbooks and other studies. Sutures closure occurred from their endo-cranial to ecto-cranial aspects. Closure of skull sutures occurred earlier in male than in females. The most successful estimate was done from sagittal suture, next lambdoid suture and then coronal suture. Studies of the ecto-cranial suture closure have the potential to underestimate age and to overcome this, study of both endo-cranial and ecto-cranial suture closure should be done.

ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors /publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

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