Analysis of hyoid bone variations to estimate sex, age, and morphology: A study on the Croatian population for forensic applications

The hyoid bone plays a significant role in forensic science, primarily cause and mechanism of death evaluation. It can also aid in biological profiling, including sex and age estimation and the study of biological variations. This study examined hyoid bone variation in the Croatian population and developed sex and age estimation models for forensic applications. On 220 multi-slice computed tomography (MSCT) scans containing hyoid bones (ages 18–92; 102 females, 118 males), landmarks were placed to classify the bones by shape, symmetry, isometry, and fusion category. Sex was estimated with 86.67% accuracy during cross-validation and 87.50% in the test set using just three interlandmark distances. For age estimation, 96%-100% of individuals with a fusion score of 4 were correctly classified as older than 34. Notably, 66.82% of hyoid bones were asymmetric, and the D shape was most prevalent. To facilitate transparency and reproducibility, a publicly accessible web-based application supporting probabilistic sex estimation and fusion-based age-related interpretation was developed (https://huggingface.co/spaces/ijerkovic/CroHyoIdea).