Morphology and topography of the supraorbital notch and foramen in medieval and contemporary skulls.

BACKGROUND: The supraorbital foramen or notch constitutes an important anatomical landmark for maxillofacial surgery, regional anesthesia, and ophthalmologic procedures. Considerable variability in its morphology and location has been reported in different groups. The aim of the study was to assess the morphological and morphometric variability of the supraorbital foramen in medieval and contemporary skulls and to analyze its asymmetry and clinical relevance. MATERIALS AND METHODS: The study included 234 adult male skulls originating from Central European skeletal samples: 87 contemporary skulls from the early 20th century and 147 medieval skulls (11th-16th centuries). Morphological assessment included identification of the supraorbital notch, complete foramen, and incomplete foramen. Morphometric measurements were performed using an electronic caliper and included distances between the supraorbital foramen and selected anthropometric landmarks. Statistical analysis was performed using Student's t-test, paired Student's t-test, and chi-square test with Yates correction. RESULTS: The supraorbital notch occurred in 54.5% of contemporary skulls and 71% of medieval skulls. The frequency of a complete supraorbital foramen did not differ significantly between the groups. In the contemporary group, significantly greater distances were observed between the supraorbital foramen and the frontozygomatic suture as well as the superior temporal line. Most other morphometric parameters did not show statistically significant differences between the groups. A small but consistent side asymmetry of the supraorbital region was observed. CONCLUSIONS: The supraorbital notch is the predominant morphological variant in both medieval and contemporary groups. Although certain differences in lateral frontal bone measurements were observed, the general topography of the supraorbital foramen appears relatively stable. The observed variability and asymmetry should be considered during surgical and anesthetic procedures involving the supraorbital region.