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Morphological types and localization patterns of pterion in the skulls of adults from southeastern China

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Abstract

Purpose

To study the morphological types and relative location of the pterion and its precise relationship with the middle meningeal artery (MMA) in the skulls of adults from southeastern China.

Methods

Dry skulls (n = 250) of adults were obtained from a university specimen bank and analyzed. The morphological types of the pterions were observed. The distances from the center of the external pterion (Pec) to the relevant intracranial and extracranial marker points were measured using a digital vernier caliper. The anterior, middle, and posterior end points of the external pterion were drilled perpendicular to the bone surface. The precise relationships of the external pterion with the internal pterion and the groove of the frontal branch of the MMA were observed and measured after sawing the skull.

Results

The morphological types of the pterion in the skulls of adults from southeastern China were sphenoparietal suture (SP) (85%), epipteric (12.4%), frontotemporal suture (1.4%), and stellate (1.2%) types. The mean widths of the external and internal pterions were R, 10.68 ± 4.22 mm; L, 11.13 ± 4.40 mm and R, 14.66 ± 4.04 mm; L, 14.14 ± 4.29 mm, respectively, and the width of the internal pterion was slightly longer than that of the external (P < 0.05). No significant difference in pterion width was found between the genders or sides of the skull (both P > 0.05). The distances from the Pec to the posterolateral aspect of the frontozygomatic suture, zygomatic process of the frontal bone, midpoint of the zygomatic arch, and external acoustic meatus were 29.95 ± 3.75 mm, 34.88 ± 4.08 mm, 40.86 ± 3.59 mm, and 53.79 ± 3.82 mm, respectively. These distances were slightly longer on the right side of the skull than on the left side (P < 0.01) and longer in men than in women (P < 0.01). The distances from the Pec to the frontal crest, optic canal, and anterior clinoid process were 62.79 ± 1.15 mm, 45.39 ± 2.48 mm, and 45.47 ± 2.05 mm, respectively. The external and internal pterions were not on the same level, and all the internal pterions were located below the external ones. In the vast majority of the skulls, the groove of the frontal branch of the MMA passed through the posterior end of the external pterion (Pep) or the area between the Pec and Pep.

Conclusion

The morphology of the pterion in the skulls of adults from southeastern China is predominantly of the SP type, mostly symmetrically distributed. The distance from the pterion to the extracranially relevant marker points differs among the ethnic groups, between the genders, and between the sides of the skull. All the internal pterions are located below the external ones. Most of the frontal branch of the MMA is located below the mid-posterior segment of the lateral pterion. The characterization of the morphology, the relative position of the pterion and the precise relationship of this structure with the MMA in the skulls of adults from southeastern China may provide an anatomical basis for teaching and clinical practices.

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Availability of data and material

The data sets supporting the results of this article are included within the article and its supplemental files.

Code availability

Not applicable.

Abbreviations

Pec:

Center of the external pterion

ZA:

Zygomatic arch

FZS:

Frontozygomatic suture

MMA:

Middle meningeal artery

SP:

Sphenoparietal suture

FT:

Frontotemporal suture

Ep:

Epipteric

St:

Stellate

ZPFB:

Zygomatic process of the frontal bone

EAM:

External acoustic meatus

Pea:

Anterior of the external pterion

Pep:

Posterior of the external pterion

Pic:

Center of the internal pterion

Pia:

Anterior of the internal pterion

Pip:

Posterior of the internal pterion

FC:

Frontal crest

OC:

Optic canal

ACP:

Anterior clinoid process

ICC:

Intraclass correlation coefficients

SR:

Sphenoid ridge

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Acknowledgements

The authors are grateful to the donors for donating their bodies to science and thereby making possible this anatomical research. Results from such research can potentially increase the overall knowledge of mankind and consequently improve patient care. Therefore, these donors and their families deserve our highest gratitude.

Funding

this work was supported by the (1) Sanming Project of Medicine in Shenzhen (No. SZZYSM202108013); (2) Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No. ZYYCXTD-C-202003).

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Author notes

  1. Junhua Li and Han Yang contributed equally to this work. Junhua Li is the first author, and Han Yang is the co-first author.

Authors and Affiliations

  1. School of Traditional Chinese Medicine, Southern Medical University, 510515, Guangzhou, China

    Junhua Li, Han Yang & Yikai Li

  2. HeNan University of Chinese Medicine, Zhengzhou, China

    Liangliang Ma

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  1. Junhua Li
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  2. Han Yang
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Contributions

JH L and H Y designed this study and drafted the manuscript. LL M provided advice and assisted in the statistical analysis. YK L reviewed the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Yikai Li.

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Conflict of interest

The authors have no conflicts of interest to disclose.

Consent to participate

All the methods in the study were carried out in accordance with the Helsinki guidelines and declaration. Ethical approval for this study was obtained from the Chinese Ethics Committee of Registering Clinical Trials (Reference number: ChiECRCT20210191).

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Li, J., Yang, H., Ma, L. et al. Morphological types and localization patterns of pterion in the skulls of adults from southeastern China. Surg Radiol Anat 44, 913–924 (2022). https://doi.org/10.1007/s00276-022-02939-2

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  • DOI: https://doi.org/10.1007/s00276-022-02939-2

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