Morphometry of Pterion and its Relation with Middle Meningeal Artery in Dry Human Skulls- A Cross-sectional Study

Abstract

Introduction: On the side of skull bone in both sides there is a significant area Pterion which acts as a landmark in neurological surgeries. All four bones meet here at this H-shaped sutural junction. Knowledge of various types of pterions and position is important in neurosurgeries, interpretation of radiographs and in forensic medicine. Aim: To analyse the morphometry of pterion and its relation with nearest branch of Middle Meningeal Artery (MMA) in dry human skulls of Davangere, Karnataka, India. Materials and Methods: The present cross-sectional study was conducted on 100 adult dry human skull bones, 200 pterions at Shamnur Shivashankarappa Institute of Medical Sciences and Research Centre, Davangere, Karnataka, India for a period of one year October 2017 to September 2018. Murphy’s classification was used for the type of pterion. Mean distance between centre of pterion to different bony landmarks on external as well as internal aspects of skull on both sides was measured. Unpaired t-test was employed to analyse the data. The p-value of <0.05 was taken as statistically significant. Results: Sphenoparietal 161 (80.5%) type of pterion was found to be the commonest followed by epipteric 20 (10%), stellate 10 (5%) and frontotemporal 9 (4.5%). Mean distance between the pterion and point nearest to branch of MMA was 2.39 mm on the right-side and 2.19 mm on the left-side of the skull with significant difference. Conclusion: It can be concluded that sphenoparietal type is the commonest type followed by epipteric, stellate and frontotemporal type. No difference was found between right and left-side pterions in type or its relations to bony landmarks.