A Morphometric Study of Pterion and its Clinical Significance for Brain Surgery

 Pterion is a suture that is located in the lateral side of the skull in the depth of which there are middle meningeal vessels, the root of the lateral sulucus, the sinus cavernus, the bruca area and the insula cortex. In addition, it is a landmark for craniotomy and surgical approaches in tumors of the Willis ring or the frontal lobe for neurosurgeons. Due to the importance of pterion morphometry for neurologists, in the present study, morphometric indices of pterion and its types were studied in dry skulls.

This descriptive study was performed on 37 skulls with no deformity and pathologic problems in 2017-2018. The vertical distance of the pterion to the center of the zygomatic arch and its horizontal distance to the frontosigmatic suture were measured. Murphy division was used to investigate the types of pterions. Finally, the data were entered into SPSS software and analyzed with descriptive statistics and T-test.

A total of 37 skulls were examined. The mean vertical distance of the pterion to the center of the zygomatic arc was 1.99 ± 1.41 cm and the mean horizontal distance of the pterion to the frontosigmatic suture was 2.80 ± 0.76 cm. The frequency of the sphenoparital, frontotemporal, stellate, and epipetric types were 89.1%, 5.4%, 2.7%, and 2.7%, respectively. The statistical test did not show any significant difference between the distance between the pterion and the zygomatic arch (p = 0.16) on the left and right. There was a significant difference between the pterion and the fento-zygomatic suture on the left and right (p = 0.005).

The study of morphological features of the skull bone is useful for neurologists, forensic specialists, and anatomists. However, other studies with a higher sample size on the skull bone, as well as radiographs and CT scans in different parts of the country appear necessary.