Stefanel Maria Eduarda Ramos, de Souza Lígia Melissa, de Aquino Macedo Fernanda Thomaz, Moreira Débora Duarte, Silva Rhonan Ferreira, Angelakopoulos Nikolaos, Vieira Walbert Andrade, Paranhos Luiz Renato, Franco Ademir
Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Rua José Rocha Junqueira 13, Office 03, Block E, Swift, São Paulo, Campinas, 13.045-755, Brazil.
Division of Oral Radiology, Faculdade São Leopoldo Mandic, São Paulo, Campinas, Brazil.
Forensic Sci Med Pathol. 2025 Mar 22. doi: 10.1007/s12024-024-00906-4.
The mastoid triangle is the area between the craniometric landmarks Mastoidale (Ma), Asterion (Ast) and Porion (Po), which has been studied in the field of physical anthropology as an alleged tool for sexual dimorphism. The evidence in the current scientific literature, however, is disputable. This systematic review aimed to find out how safe is the mastoid triangle for sexual dimorphism. A research protocol submitted to PROSPERO (CRD42023488216) was designed based on PRISMA-P. Pubmed, SciELO, LiLACS, LIVIVO, Open Gray and Open Access Theses and Dissertations were searched with structured strategies. The Joanna Briggs Institute manual was followed and the critical appraisal checklist for cross-sectional studies was used. The search found 14 eligible studies out of 2148 initially screened. The combined sample consisted of 1604 human skulls. Eight studies (57,14%) clearly encouraged the use of the mastoid triangle for sexual dimorphism, while three (21,42%) advised against it. All the studies had a low risk of bias (75-100%). The standardized mean difference between male and females was between 1.00 and 1.42 without statistically significant differences between geographic regions (p > 0.05). Expressive heterogeneity and large confidence intervals were detected, showing great variability across studies. A country-specific subgroup meta-analysis revealed lack of statistically significant differences based on geographic regions. This systematic review showed low level of evidence to support the use of the mastoid triangle as a tool for sexual dimorphism.
乳突三角是颅骨测量标志乳突点（Ma）、星点（Ast）和耳点（Po）之间的区域，在体质人类学领域，它被作为一种所谓的性别二态性工具进行了研究。然而，当前科学文献中的证据存在争议。本系统评价旨在查明乳突三角用于性别二态性研究的安全性如何。基于PRISMA-P设计了一项提交给国际系统评价前瞻性注册库（CRD42023488216）的研究方案。采用结构化策略在PubMed、SciELO、拉丁美洲及加勒比地区卫生科学数据库（LILACS）、LIVIVO、开放灰色文献库和开放获取学位论文数据库中进行检索。遵循乔安娜·布里格斯研究所手册，并使用横断面研究的关键评价清单。在最初筛选的2148项研究中，检索到14项符合条件的研究。合并样本包括1604个人类头骨。八项研究（57.14%）明确鼓励使用乳突三角进行性别二态性研究，而三项研究（21.42%）则表示反对。所有研究的偏倚风险较低（75%-100%）。男性和女性之间的标准化平均差异在1.00至1.42之间，不同地理区域之间无统计学显著差异（p>0.05）。检测到明显的异质性和较大的置信区间，表明各研究之间存在很大差异。一项针对特定国家的亚组Meta分析显示，基于地理区域不存在统计学显著差异。本系统评价表明，支持将乳突三角用作性别二态性工具的证据水平较低。
