Morehouse Jessica L, Korbel Erica L, Sloan Sara S
Department of Anatomy and Pathological Sciences, Kansas City University College of Osteopathic Medicine, 1750 Independence Avenue, Kansas City, MO, 64106, USA.
Surg Radiol Anat. 2025 May 30;47(1):151. doi: 10.1007/s00276-025-03668-y.
The pterion is an anatomic landmark formed via junction of the temporal, sphenoid, parietal, and frontal bones on the lateral aspect of the cranium. Due to the proximity to the middle meningeal artery (MMA), pterion-based surgical approaches have a potential risk of arterial rupture, leading to subsequent epidural hematoma formation. This study characterized the localization of the pterion and its relationship to the MMA in the four main pterion configurations.
Ninety-one pterions were exposed, and suture patterns were uncovered to determine pterion classification. Dura mater was removed to expose the groove for the MMA and relationship to the pterion, documenting the presence or absence of a bony bridge. Skull thickness at the pterion center was collected for each specimen.
Sphenoparietal (Type I) pterions were present in 67.03%, Frontotemporal (Type II) in 10.99%, Stellate (Type III) in 16.48%, and Epipteric (Type IV) in 5.49% of specimens, with non-identical pterion types located bilaterally in 47.62%. A significant difference was found in five of the eight measurements obtained between male and female cadavers, including the distance to the frontozygomatic suture (FZMS). The distance between pterion center and the groove for the MMA, as well as skull thickness, also demonstrated statistical significance, with the smallest distance and skull thickness demonstrated in Type III pterions.
Type I is the most prevalent pterion configuration, with Type III most closely situated to the course of the MMA. This study demonstrates the importance of determining pterion type pre-operatively to ensure vascular preservation of MMA.
翼点是颅骨外侧由颞骨、蝶骨、顶骨和额骨交汇形成的解剖标志。由于靠近脑膜中动脉（MMA），基于翼点的手术入路有动脉破裂的潜在风险，进而导致硬膜外血肿形成。本研究描述了四种主要翼点构型中翼点的定位及其与MMA的关系。
暴露91个翼点，揭示缝线模式以确定翼点分类。去除硬脑膜以暴露MMA沟及其与翼点的关系，记录是否存在骨桥。收集每个标本翼点中心处的颅骨厚度。
蝶顶型（I型）翼点占标本的67.03%，额颞型（II型）占10.99%，星型（III型）占16.48%，翼上型（IV型）占5.49%，双侧翼点类型不同的占47.62%。在男性和女性尸体获得的八项测量中有五项存在显著差异，包括到额颧缝（FZMS）的距离。翼点中心与MMA沟之间的距离以及颅骨厚度也显示出统计学意义，III型翼点的距离和颅骨厚度最小。
I型是最常见的翼点构型，III型与MMA走行最接近。本研究表明术前确定翼点类型对于确保MMA血管保护的重要性。
