https://www.ijmhr.org/ijar.htm editor_anatomy@ijmhr.org
ISSN:       2321-4281 (E) 2321-8967 (P)

IJAR.2016.484

DOWNLOAD PDF
Table of Contents

Type of Article:  Original Research

Volume 5; Issue 1 (January 2017)

Page No.: 3384-3388

DOI: https://dx.doi.org/10.16965/ijar.2016.484

MORPHOLOGY AND MORPHOMETRIC ANALYSIS OF PTERION WITH ITS NEUROSURGICAL IMPLICATIONS IN PTERIONAL APPROACH

K Ephraim Vikram Rao *1 , B Sadananda Rao 2, B H Shiny Vinila 3.

*1 Assistant professor, Department of Anatomy, Deccan College of Medical Sciences, Hyderabad, Telangana, India.

2 Associate Professor, Department of Anatomy, Kamineni Academy of Medical Sciences, Hyderabad, Telangana, India.

3 Senior Lecturer, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Center, Hyderabad, Telangana, India.

Corresponding Author: Dr. K Ephraim Vikram Rao, Assistant Professor, Department of Anatomy, Deccan College of Medical Sciences, Santhosh Nagar, Hyderabad,500058, Telangana, India. Mobile Number: 09949353025

E-Mail: drvikram.anat@gmail.com, dr.ephraimvikram@gmail.com

ABSTRACT:

Introduction: Pterional approach is a minimally invasive procedure to reach the anterior and middle cranial fossae. Location of the pterion was observed to be race specific, which could be due to genetic or environmental factors affecting the craniometric indices of human skull. The present study aimed to find out the incidence of various sutural patterns of pterion and also to determine the location of pterion which would be of immense benefit while performing pterional approaches in micro neuro surgical procedures on south Indians.

Materials and Methods: The present study was carried out on 140 pterions of 70 dry human adult skulls of unknown sex. The sutural pattern of the pterion was determined on both sides of each skull, based on Murphy’s classification. Measurements were taken from the center of pterion to mid point on zygomatic suture, posterolateral aspect of frontozygomatic suture, anterosuperior margin of external auditory meatus and inferior margin of mastoid process.

Results:  The incidence of sphenoparietal pattern was predominant with 77.5%, frontotemporal type was 4.16 %, stellate type was 5.83 % and epipteric type was observed to be 12.5%. The average distance from the center of pterion to mid point on zygomatic arch was 37.40±3.92 mm, from the center of pterion to posterolateral aspect of frontozygomatic suture was 30.43±4.36 mm, from the center of pterion to anterosuperior margin of external auditory meatus was 51.67±3.96 mm, from the center of pterion to inferior aspect of mastoid process was 80.04±6.22 mm. There were no significant side variations in the distance from the midpoint of pterion to all the four anatomical landmarks.

Conclusion: The location of pterion and the variations in the sutural patterns of pterion plays an important role while performing pterional approaches in neurosurgical procedures on south Indians.

KEY WORDS: Pterional approach, Pterion, Sutural patterns, Sphenoparietal, Mastoid process.

REFERENCES

  1. Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al. The skull. In. Gray’s Anatomy, 38 th ed. London: Churchill Livingstone; 1995:583-606.
  2. Broca, P. Instruction craniologiques et craiometriques. Mem. Soc. Anthrop 1875. Paris, 2:1-203.
  3. Murphy. The pterion in the Australian aborigine. The American Journal of Physical Anthropology. 1956;14(2):225-244.
  4. Lama, M. & Mottolese, C. Middle meningeal artery aneurysm associated with meningioma. J. Neurosurg. Science. 2000;44:39-41.
  5. Ersoy M., Evliyaoglu C., Bozkurt M., Konuskan B., Tekdemir I., Epipteric bone in the pterion may be a surgical pitfall, Minim. Invas. Neurosurg., 2003;46:363-5.
  6. Hari Prasad, N. K. Bezbaruah, Anshu Mishra, Parmatma Prasad Mishra. Morphometric analysis of pterion: Aclinic-anatomical study in north Indian dry skulls. Innovative Journal of Medical and Health Science. 2015;5(5):201-205.
  7. Urzi F., Iannello A., Torrisi, A., Foti, P., Mortellaro, N.F., Cavallaro, M. Morphological variability of pterion in the human skull. Ital. J. Anat. 2003;108:83-117.
  8. Mori K, Osada H, Yamamoto T, Nakao Y, Maeda M. Pterional keyhole approach to middle cerebral artery aneurysms through an outer canthal skin incision. Minim Invasive Neurosurg. 2007;50(4):195-201.
  9. Cheng WY, Lee HT, Sun MH, Shen CC. A pterion keyhole approach for the treatment of anterior circulation aneurysms. Minim Invasive Neurosurg. 2006;9:257-262.
  10. Mwachaka, PM., Hassanali, J. and Odula, P. Sutural morphology of the pterion and asterion among adult Kenyans. Braz. J. Morphol. Sci., 2009;26(1):4-7.
  11. LIU, Y., TANG, Z., KUNDU, RK., WU, L., LUO, W., ZHU, D. et al. Msx2 gene dosage influences the number of proliferative oesteogenic cells in growth centres of the developing murine skull: a possible mechanism for MSX2-mediated craniosynostosis in humans. Dev Bio, 1999;205:260-274.
  12. ASHLEY-MONTAGU, MF. The anthropological significance of the pterion in the Primates. American Journal pf Physical Antropology. 1933;18(2):159-336.
  13. KIM, HJ., RICE, DPC., KETTUNEN, PJ. and THESLEFF, I. FGF-, BMP- and Shh-mediated signaling pathways in the regulation of cranial suture morphogenesis and calvarial bone development. Development. 1998;125(7):1241-1251.
  14. Ankur Zalawadia, Jignesh Vadgama, Srushti Ruparelia, Shailesh Patel, S. P. Rathod, S. V. Patel. Morphometric Study of Pterion In Dry Skull Of Gujarat Region. NJIRM. 2010;1(4):25-29.
  15. Walulkar S, Dehankar R, Walulkar M, Ksheersagar DD. Pterion formation and its variations in Human Skull in Vidarbha Region. J Cont Med A Dent. 2016;4(2):58-61.
  16. Ukoha U., Oranusi C.K., Okafor J.I., Udemezue O.O., Anyabolu A.E., Nwamarachi T.C., Anatomic study of the pterion in Nigerian dry human skulls, Nigerian Journal of Clinical Practice. 2013;16(3):325-328.
  17. Eboh D. E. O. & Obaroefe M., Morphometric study of pterion in dry human skull bones of Nigerians, Int. J. Morphol., 2014;32(1):208-213.
  18. Apinhasmit W., Chompoopong S., Chaisuksunt V., Thiraphatthanavong P., Phasukdee N., Anatomical consideration of pterion and its related references in Thai dry skulls for pterional surgical approach, Journal Of The Medical Association Of Thailand Chotmaihet Thangphaet. 2011;94(2):205-214.
  19. Suchith Kumar., Anurag, Munjal S., Chauhan P., Chaudhary A., Jain S. K., “Pterion its location and clinical implications- A Study Compared”. Journal of Evolution of Medical and Dental Sciences. 2013;l2(25):4599-4608.

Cite this article: K Ephraim Vikram Rao, B Sadananda Rao, B H Shiny Vinila. MORPHOLOGY AND MORPHOMETRIC ANALYSIS OF PTERION WITH ITS NEUROSURGICAL IMPLICATIONS IN PTERIONAL APPROACH. Int J Anat Res 2017;5(1):3384-3388. DOI: 10.16965/ijar.2016.484