Mastoid notch as a landmark for localization of the transverse-sigmoid sinus junction

Abstract

Background: The top of the mastoid notch (TMN) is close to the transverse-sigmoid sinus junction. The spatial position relationship between the TMN and the key points (the anterosuperior and inferomedial points of the transverse-sigmoid sinus junction, ASTS and IMTS) can be used as a novel method to precisely locate the sinus junction during lateral skull base craniotomy. Methods: Forty-Three dried adult skull samples (21 from males and 22 from females) were included in the study. A rectangular coordinate system on the lateral surface of the skull was defined to assist the analysis. According to sex and skull side, the data were divided into 4 groups: male&left, male&right, female&left and female&right. The distances from the ASTS and IMTS to the TMN were evaluated on the X-Axis and Y-Axis, symbolized as ASTS&TMN-x, ASTS&TMN-y, IMTS&TMN-x and IMTS&TMNy. Results: Among the four groups, there was no significant difference in ASTS&TMN-x (p = 0.05) and ASTS&TMN-y (p = 0.3059), but there were significant differences in IMTS&TMN-x (p < 0.001) and IMTS&TMN-y (p = 0.01), and multiple comparisons indicated that there were significant differences between male&left and female&left both in IMTS&TMN-x (p = 0.0006) and in IMTS&TMN-y (p = 0.0081). In general, the ASTS was located 1.92 mm anterior to the TMN on the X-Axis and 27.01 mm superior to the TMN on the Y-Axis. For the male skulls, the IMTS was located 3.60 mm posterior to the TMN on the X-Axis and 14.40 mm superior to the TMN on the Y-Axis; for the female skulls, the IMTS was located 7.84 mm posterior to the TMN on the X-Axis and 19.70 mm superior to the TMN on the Y-Axis. Conclusions: The TMN is a useful landmark for accurately locating the ASTS and IMTS.