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        Reappraising the neurosurgical significance of the pterion location, morphology, and its relationship to optic canal and sphenoid ridge and neurosurgical implications

        Venkatesh G. Kamath,Milan Hande 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.4

        Frontolateral craniotomy procedures have advanced from conventional craniotomy to mini-craniotomy, and to contemporary keyhole surgery. In this context, it is important for the neurosurgeon to precisely locate the pterion. The distance of the pterion center from midpoint of zygomatic arch and posterolateral margin of frontozygomatic suture was studied bilaterally in 50 whole adult skulls in Indian ethnic group. The depth of optic canal and sphenoid ridge from the pterion was recorded bilaterally in fifty cut adult skulls and fifteen three-dimensional computed tomography scans. The suture length, thickness, and morphology were studied. The data were analyzed using SPSS software, two-tailed Student’s t test, binary logistic regression and receiver operating characteristic curve for sexual dimorphism. The pterion center was located at a mean distance of 37.02 mm above the midpoint of zygomatic arch, 28.20 mm behind the posterolateral margin of frontozygomatic suture, 42.73 mm lateral to the optic canal and 10.59 mm from the sphenoid ridge. The location did not exhibit sexual dimorphism. In 20% cases the pterion center was 40 mm or more above the midpoint of the zygomatic arch and in 5% cases 35 mm or more posterior to the posterolateral margin of frontozygomatic suture. The mean suture length was 10±3 mm. The mean thickness at the center of the pterion was 3.52±1.45 mm. The commonest variety was sphenoparietal followed by frontotemporal, epipteric, and stellate types. A thorough knowledge of these dimensions has innumerable neurosurgical implications in resection of sellar, parasellar, and paraclinoid tumors and circulatory aneurysms.

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        Binary logistic regression analysis of hard palate dimensions for sexing human crania

        Venkatesh Kamath,Muhammed Asif,Radhakrishna Shetty,Ramakrishna Avadhani 대한해부학회 2016 Anatomy & Cell Biology Vol.49 No.2

        Sex determination is the preliminary step in every forensic investigation and the hard palate assumes significance in cranial sexing in cases involving burns and explosions due to its resistant nature and secluded location. This study analyzes the sexing potential of incisive foramen to posterior nasal spine length, palatine process of maxilla length, horizontal plate of palatine bone length and transverse length between the greater palatine foramina. The study deviates from the conventional method of measuring the maxillo-alveolar length and breadth as the dimensions considered in this study are more heat resistant and useful in situations with damaged alveolar margins. The study involves 50 male and 50 female adult dry skulls of Indian ethnic group. The dimensions measured were statistically analyzed using Student’s t test, binary logistic regression and receiver operating characteristic curve. It was observed that the incisive foramen to posterior nasal spine length is a definite sex marker with sex predictability of 87.2%. The palatine process of maxilla length with 66.8% sex predictability and the horizontal plate of palatine bone length with 71.9% sex predictability cannot be relied upon as definite sex markers. The transverse length between the greater palatine foramina is statistically insignificant in sexing crania (P=0.318). Considering a significant overlap of values in both the sexes the palatal dimensions singularly cannot be relied upon for sexing. Nevertheless, considering the high sex predictability of incisive foramen to posterior nasal spine length this dimension can definitely be used to supplement other sexing evidence available to precisely conclude the cranial sex.

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