Cranio-facial anthropometric study of adult population in Kerala

 

 

Abstract              Background: Craniometric measurements of the skull can identify the skulls of different races based on the cepahalic index estimated from the length and breadth of skull. Gender differentiation is also possible from the measurements of skull in addition to the anatomical characteristics to discern sex. Similarly, facial and nasal indices can be determined from the length and breadth of face and nose. These lengths and indices are helpful in differentiating sex as well as the types of face and nose of the study population. In the present study using sliding and spreading digital calipers craniofacial measurements of randomly selected 200 adults (100 males and 100 females) hailing from different regions of Kerala, were taken. The results obtained were statistically analysed and found to be significant.

Key Words: Craniometry, Cephalic index, Dolichocephalic, Mesocephalic, Hyperbrachycephalic, Nasal index, Mesorrhine, Platyrrhine, Leptorrhine, Facial index, Euryprosopy, Mesoprosopy, Leptoprosopy, Hyperleptoprosopy, Hypereuryprosopy.

 

INTRODUCTION

Establishing identity of a living individual or a mutilated or skeletonised dead body sometimes poses problems in medico-legal investigations. The main basic parameters to determine identity are the race/ethnicity, sex age and stature.¹ Determination of the race becomes a material point in identifying mutilated dead bodies in mass disasters like crash of an international airliner where the passengers may be an admixture of different races of the world.² Racial characteristics are best observed from the measurements of length and breadth of skull and estimating the cephalic index.^3,4 Based on this the type of head can be determined. From the measurements of the height of nose, breadth of nose, length of face and breadth of face, nasal and facial indices can be calculated. These will help in categorising the type of noses and faces of the population studied. Moreover, these measurements are statistically significant in differentiating the gender.

 

Objectives of the study

Primary objective was to determine the cranio-facial anthropometric norms of the adult population of Kerala such as shape of head, nose and face.

The secondary objective was to determine the gender differences from the measurements of head, nose and face.

 

 

 

MATERIALS AND METHODS

Present study was undertaken by the Department of Forensic Medicine of Amrita School of Medicine, one of the institutions under the Amrita Institute of health care sector which has a 1450 bedded hospital. There are 6191 people (2208 males and 3983 females) in the campus hailing from different parts of Kerala State. Therefore this study group can be considered as a cross section of the Kerala population. After analysing the previous studies ^{5, 6, 7} and with 20% allowable error and 95% confidence, minimum sample size was determined to be less than 40 (20 males and 20 females) However using random sample method 200 subjects (100 males and 100 females) were selected from the entire list of study population of the age group between 20-50 years hailing from all the districts. After obtaining written informed consent from the subjects; personal identification, demographic data, medical and surgical history and craniofacial measurements were obtained and recorded in the proforma prepared. Subjects having any congenital or acquired craniofacial malformations were excluded. Using sliding (Fig 1) and spreading digital calipers (Fig. 2), following craniofacial measurements were taken from each subject who was seated comfortably in a chair with the head kept in the anatomical position.

 Figure 1. Sliding digital caliper;    Figure 2. Spreading digital caliper

 

Anatomical and anthropological landmarks are marked on the head (Fig. 3).Maximum length of head is the maximum antereoposterior diameter measured from ‘Glabella’ to ‘Inion’ (Fig.4). Glabella is an anatomical point just above the root of nose between the eyebrows, intersected by the mid-sagittal plane. Inion is the distal most point placed on the external occipital protuberanace (Fig.3). Maximum breadth of head is the distance between two ‘Euryons’ (Fig.5). Euryon is the point of maximum protuberance in the parietal bones (Fig 3). Cephlic index was calculated by multiplying the breadth of head by 100 and dividing it by the length of head. Depending upon the indices, the types of head were classified (Table 1) as given by Williams (1995).⁸

 

Figure 3: Anatomical and anthropological landmarks of the head

 

Figure 4                                      Figure 5

Figure 4: Taking the length of head using the spreading caliper; Figure 5: Taking the breadth of head using the spreading caliper

Height of the nose was measured (Fig. 6) from the ‘nasion’ to ‘subnasale’. Breadth of nose was measured as the maximum breadth at right angle to the nasal height from ‘ala’ to ‘ala’ (Fig. 6 AandB). These measurements were taken with digital sliding calipers. Nasion is the point on the root of nose where the mid sagittal plane cuts the nasofrontal suture. Subnasale is the point at which the nasal septum merges with the upper cutaneous lip in the mid sagittal plane. Ala is the prominent point on the lateral wall of the nose. The nasal index was calculated by multiplying the breadth of nose with hundred and dividing it by the height of the nose. On the basis of nasal index, Martin and Sallar (1957) has divided nose into three types ^{8, 9, 10} Maximum length of face was measured from ‘nasion’ to ‘gnathion’. Maximum breadth of nose was measured between the farthest points on the ‘Zygomatic arches’ on both sides (Fig. 7 A andB). Nasion is the intersection of the nasofrontal suture with the mid sagittal plane. Nasion is the uppermost landmark for measuring the facial length. Gnathion is the most anterior and lowest median pont on the border of mandible. Bizygomatic breadth is between the farthest points on the zygomatic arches. The facial index is calculated by multiplying the length of face with hundred and dividing it by the breadth of face. The facial index was classified on the basis of international descriptions (Williams et al. 1995) into five types ^9,11. All the measurements and indices were subjected to statistical analysis using SPSS (Statistical package for social sciences) version 20 and various parameters were compared using student ‘t’ test.

 

Figure 6 A and B: Taking the length (A) and breadth of nose (B) using the sliding caliper

 

Figure 7 A and B: Taking the length and breadth of face using the sliding caliper

DISCUSSION

In the present study of 200 subjects, cephalometric measurements of the head, nose and face were taken. From the mean length and breadth of head, cephalic index was calculated. Based on the cephalic index, 89 subjects (44.5%), were categorised as dolichocepahlic and 68 subjects were mesocephalic (34%). There was not much difference in the male-female ratio also. When the mean cephalic indices were analysed statistically there was no significant gender discrimination (p value, 0.100). But when the mean length and breadth of head in the study subjects were analysed statistically it was found to be statistically significant in differentiating gender. In a study conducted by Mahesh kumar et al. 12 (2013) in 600 subjects from Haryanvi Banya caste of Haryana it was revealed that 463 were dolichocephalic (77%). Mesocephalic type of head ranks next (17%). Twisha shah et al. 13 (2015) had determined the cephalic index of 901 Gujarathis and 300 non Gujarathis of Ahemadabad. Among the Gujarathis 40.5 % subjects were dolichocephalic and 40.7 were mesocephalic. Among non Gujarathi population 62.3 % of the subjects were dolichocephalic. Mesocephalic was 18%. This result is more or less similar to the present study. Sunita Patro 14 (2014), had conducted a similar study among 1030 subjects aged above 18 years of south Odisha and it was found that 58.7% subjects were mesocephalic. Of the subjects 19.5% were dolichocephalic. This shows that there is a difference in the type of head of Kerala population and Oriyas. In a similar study conducted by Priti Nemade 5 (2014) among 320 Maharashtrians in the age group of 20-30 years, 44% were mesocephalic. Dolichocephalic type of head was seen only in 19% of the subject. This shows that there is difference in the type of head of Maharashtrians and Kerala Population. In the present study, measurements of the height and width of nose were taken and nasal index of the study population was determined. Based on the nasal index shape of the nose of study subjects was categorised into three types such as Leptorrhyne, Mesorrhyne and Platyrrhyne. Of the study population 55.5 percent had Mesorrhyne type of nose. Leptorhyne type of nose was seen in 35% of the study subjects. In the study group, males were predominantly Mesorrhyne (69%) and females were Leptorrhyne (51%). The present study also revealed that the mean nasal indices of males and females are statistically significant in gender differentiation. The mean breadth of nose was also statistically significant in determining sex. But mean length had no significance. Girish Patel et al. 15 (2014) had conducted a study among 250 subjects of south Indian population in the age group of 18-30 years. Majority of the males of this group were having a mesorrhyne type of nose, while the females were having a leptorrhyne type of nose. This result is similar to that of the present study. Moreover the results were statistically significant also. Sharma S.K et al. 16 (2014) in a study conducted among 204 subjects of Hindu community of Gwalior in the age group of 19-45 years found out that 63.7% of the subjects were having a mesorrhyne type of nose. Platyrrhine type of nose was found in 21.57% of the subjects. The first majority of the present study is similar to the Gwalior group. But second majority is different. Platyrrhine type of nose was seen only in 9.5% of the present study group. In the present study measurements of the length and breadth of the face were taken and facial index was calculated. Based on this, the type of face were classified into five types(Table 3). Of the study group 66% were having hyperleptoprospic type of face. Leptoprosopic type of face was seen in 19% of the total subjects. The mean facial index, mean facial length and breadth are found to be statistically significant in differentiating gender. Shetty R V et al. 6 (2011) had studied the facial measurements of 300 medical students of Manipal in the age group of 18-22 years. Of the 300 students 200 were from Malaysia. 29% of the the Malaysian population were having Mesoprosopic face. Of these subjects, 27% were Leptooprosopic. Among the Non Malaysians, 31% were having a Mesoprospic type of face. 30% were Euryprosopic.This finding is dissimilar to the observations of the present study. Maheshkumar et al. 17 (2013) had studied the types of face in 600 Haryanvi Banyas. 42% of the study subjects were having a mesoprosopic type of face. 21.6% of the group was Euryprosopic. The results are dissimilar to the present study.

 

CONCLUSION

In the present study conducted among 200 adults between the age group of 20-50 years hailing from different districts of Kerala, craniofacial measurements such as the lengths (height) and breadths of head, nose and face were taken to estimate the cephalic, nasal and facial indices.

The cephalic index determines the shape of head. Nasal and facial indices determine the type of nose and face. Some of the measurements were found to be statistically significant in differentiating the gender also. The present study arrived at the following conclusions: -

1. The mean length and breadth of the head are statistically significant in differentiating the gender.
2. Cephalic index calculated from the length and breadth of head and based on it the shape of head was categorised into four types viz dolichocephalic, mesocephalic, brachycephalic and hyperbrachycephalic.
3. The majority of the present study group (44%) were having a dolichocephalic type of head; meso cephalic ranking next (34%).
4.  Cephalic index was not statistically significant in differentiationg gender.
5. Based on the nasal index , nose was categorised into 3 types viz Mesorrhyne, Leptorrhyne and Platyrrhine
6. Majority of the study popualtion had a Mesorrhine type of nose (55.5%). The next in rank is Leptorrhine (35%)
7.  Mean breadth of nose and mean nasal index are statistically significant in determining the gender. But mean height of nose has no statistical significance.
8.  Based on the mean facial index the study population was categorised into five types such as Hypereurysopy,Euryprosopy, Mesoprosopy, Leptoporosopy and Hyperleptoporosopy.
9. Majority of the study group (66%) were having a hyperleptoprospic type of face. Leptoprosopic type of face was seen in 19% of the total subjects.
10.  Mean length and breadth of face and mean facial index are statistically significant in differenti ating gender (Table 4)

Table 4. Mean cranio-facial indices in the study population

 

Scope and Limitations

The result of this study will be highly useful in forensic anthropology in the identification of unknown, unidentified dead bodies and skeletal remains. The study group of 200 subjects can be considered as a cross section of the Kerala population as they hail from all the districts of Kerala. But to have objectivity, validity and reliability of the research, the study, has to be conducted among a larger group randomly selected from each district of Kerala

 

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