Morphometric localisation of pterion for lateral neurosurgical planning and approach

To localise pterion, as a safe landmark, on dry skulls, for performing various neurosurgical procedures. To analyse the variation in the type and location of pterion among Pakistani male population.

This cross sectional study was conducted form August 2018 to May 2019 on 50 dry skulls obtained from The anatomy departments of different medical colleges of Rawalpindi and Islamabad. Shape of the pterion was noted and different measurements of the pterion from the two reference points, frontozygomatic suture and superior border of zygomatic arch, were recorded. Mean differences between the right and left sides were compared using SPSS version 23.

The pattern of pterion suture was sphenoparietal in 47 skulls, 2 skulls had epipteric type and 1 skull had a stellate type of pterion. The mean distance of pterion, on the right side, from posterolateral aspect of frontozygomatic suture was 2.490±0.596cm, 1.485±0.497cm, 2.922±0.697cm measured as horizontal, vertical and direct respectively. The mean horizontal, vertical and direct frontozygomatic measurements on the left side were 2.265±0.574cm, 1.395±0.548cm, 2.717±0.665cm respectively. The mean frontozygomatic horizontal and direct measurements were significantly greater on the right side as compared to the left side (p value 0.001). The mean distance from superior border of zygomatic arch to the centre of pterion on the right and left sides were 3.744±0.444cm and 3.644±9.473 respectively.

The findings of the study provided important information regarding the probability of type and location of pterion in Pakistani males for lateral skull neurosurgical planning, especially when CT scan facility is not available.