Comprehensive Morphometric Analysis of the Rhomboid Fossa: Implications for Safe Entry Zones in Brainstem Surgery

Area of Science:

• Neurosurgery
• Anatomy
• Morphometrics

Background:

• The rhomboid fossa (RF) is critical in brainstem surgery, housing vital structures like the reticular formation and cranial nerve nuclei.
• A detailed understanding of RF microsurgical anatomy is essential for safe neurosurgical procedures.

Purpose of the Study:

• To provide a comprehensive morphometric analysis of the rhomboid fossa (RF).
• To identify and describe safe entry zones within the RF for neurosurgical access.
• To enhance the understanding of complex RF anatomy for improved surgical outcomes.

Main Methods:

• Morphometric analysis of 45 adult human brainstems.
• Performed 13 linear measurements under 20× magnification using a millimeter graph.
• Identified key anatomical landmarks within the rhomboid fossa.

Main Results:

• The rhomboid fossa measured 34.65 mm in length and 22.61 mm in width.
• Detailed measurements of the facial colliculus, sulcus limitans incisures, and medullary striae to obex distance were recorded.
• Identified two safe entry zones: the suprafacial and infrafacial triangles, crucial for accessing dorsal pons lesions.

Conclusions:

• This morphometric analysis significantly advances the understanding of rhomboid fossa intricate anatomy.
• The identification of suprafacial and infrafacial triangles provides valuable surgical corridors.
• Precise anatomical measurements and safe entry zone descriptions serve as a critical resource for neurosurgeons performing brainstem surgeries.