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

IJAR.2017.260

DOWNLOAD PDF
Table of Contents

Type of Article:  Original Research

Volume 5; Issue 3.1 (July 2017)

Page No.: 4096-4099

DOI: https://dx.doi.org/10.16965/ijar.2017.260

A STUDY ON SUTURAL MORPHOLOGY OF THE PTERION IN ADULT DRY SKULL IN SOUTH INDIAN ETHNIC GROUP

Qudsia Sultana *1,  Mohammad Hafeezulla Shariff 2, Venkatesh Kamatth 3, Ramakrishna Avadhani 4.

*1 Assistant Professor, Department of Anatomy,  Yenepoya Medical College, Mangalore, Karnataka, India.

2 Associate Professor, Department of Pathology, Yenepoya Medical College, Mangalore, Karnataka, India.

3 Associate Professor, Department of Anatomy,  Yenepoya Medical College, Mangalore, Karnataka, India.

4 Professor, Department of Anatomy,  Yenepoya Medical College, Mangalore, Karnataka, India.

Address for Correspondence:  Dr.Qudusia Sultana, Assistant Professor, Department of Anatomy,  Yenepoya Medical College,  Mangalore,  India- 575018. Mobile: +91-7899114567. Mobile: +91- 7899114567 E-Mail: qudsia.shariff@yahoo.co.in

ABSTRACT

Introduction: The latest advances in the field of pterional keyhole surgeries make it imperative for a neurosurgeon to understand the sutural morphology of pterion prior to the surgery.

Materials and Methods: The sutural morphology of the pterion was studied bilaterally in 98adult skulls (62 male and 36 female) of south Indian ethnic group. The pterion was classified into four types namely sphenoparietal, frontotemporal, stellate and epipteric and the frequency of each type was observed bilaterally and in either sex and recorded.

Results: Sphenoparietal was observed to be the commonest type of the pterion comprising 81.61%, followed by epipteric and frontotemporal varieties comprising 7.63 and 6.63% respectively and stellate was observed to be the least common variety with 3.55%.

Conclusion: The pterion is an important neurosurgical landmark due to the presence of vital structures beneath it such as the insula, middle meningeal artery, Broca’s area, optic nerve and the circle of Willis. It provides lateral access to these structures and enables surgical treatment of vascular aneurysms of circle of Willis, tumours and optic meningiomas. The    novel advances in the field of pterional keyhole surgeries increases its significance and a neurosurgeon must essentially understand its sutural morphology prior to surgery.

Key words: Neurosurgical Implications, Pterion, Pterionic Approach, Sutural Morphology.

REFERENCES

  1. Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MWJ. The skull, In: Gray’s Anatomy, 38th Edition,Churchill Livingstone, London,1995, pp. 583–606.
  2. Murphy T. The pterion in the Australian aboriginal Am J PhysAnthropol 1956;14:225–44.
  3. Moore KL, Dalley AF. Clinically oriented anatomy, 4th Edition, Lippincott Williams & Wilkins, Baltimore, 1999, pp. 836–842.
  4. Adejuwon SA, Olopade FE, Bolaji M. Study of the Location and Morphology of the Pterion in Adult Nigerian Skulls. ISRN Anatomy 2013; 403937, 4 pages.
  5. Lovejoy CO, Meindl RS, Mensforth RP, Barton TJ. Multifactorial determination of skeletal age at death: a method a blind tests of its accuracy. Am J PhysAnthropol 1985;68:1–14.
  6. Cheng WY, Lee HT, Sun MH, Shen CC. A pterion keyhole approach for the treatment of anterior circulation aneurysms. Minim Invasive Neurosurg 2006;49:257–62.
  7. Hyun SJ, Hong SC, Kim JS. Side selection of the pterional approach for superiorly projecting anterior communicating artery aneurysms. J ClinNeurosci 2010;17:592–6.
  8. Saxena RC, Bilodi AKS, Mane SS, Kumar A.Study of Pterion in skulls of awadh area-in and around Lucknow .Kathmandu Univ Med J 2003;1:32–33.
  9. Saheb HS, Mavishetter GF, Thomas ST, Prasanna LC, Muralidhar P, Magi. A study of sutural morphology of the pterion and asterion among human adult Indian skulls. Biomedical Research 2011;22:73–
  10. Ukoha U, Oranusi CK, Okafor JI, Udemezue OO, Anyabolu AE, Nwamarachi TC. Anatomic study of the pterion in Nigerian dry human skulls. Niger J ClinPract 2013;16:325–8.
  11. 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. J Med Assoc Thai 2011;94:205–
  12. Ilknur A., Mustafa K.I, Sinan B.A comparative study of variation of the pterion of human skulls from 13th and 20th century Anatolia. J. Morphol 2009;27:1291–1298.
  13. Oguz O, Sani SG, Bozkir MG, Soames RW. The pterion in Turkish male skulls. SurgRadiolAnat 2004;26:220–
  14. Yaşargil MG, Krayenbühl N, Roth P, Hsu SP, Yaşargil DC. The selective amygdalohippocampectomy for intractable temporal limbic seizures. J Neurosurg 2010;112:168–85.
  15. Kim E, Delashaw JB Jr. Osteoplastic pterional craniotomy revisited. Neurosurgery 2011;68:125–9.
  16. Cheng WY, Lee HT, Sun MH, Shen CC. A pterion keyhole approach for the treatment of anterior circulation aneurysms. Minim Invasive Neurosurg 2006;49:257–62.
  17. Lang J. The pterion region and its clinically important distance to the optic nerve, dimensions and shape of the recess or the temporal pole Neurochirurgia 1984;27:31–35.
  18. Schick U, Dott U, Hassler W. Surgical management of meningiomas involving the optic nerve sheath. J Neurosurg 2004;101:951–9.
  19. Ersoy M, Evliyaoglu C, Bozkurt MC, Konuskan B, Tekdemir I, Keskil IS.Epipteric bones in the pterion may be a surgical pitfall. Minim Invasive Neurosurg 2003;46:363–365.

Cite this article: Qudsia Sultana, Mohammad Hafeezulla Shariff, Venkatesh Kamatth, Ramakrishna Avadhani. A STUDY ON SUTURAL MORPHOLOGY OF THE PTERION IN ADULT DRY SKULL IN SOUTH INDIAN ETHNIC GROUP. Int J Anat Res 2017;5(3.1):4096-4099. DOI: 10.16965/ijar.2017.260