Erturk Mete, Demircubuk Ibrahim, Candar Esra, Sengul Gulgun
Department of Anatomy, School of Medicine, Ege University, Izmir, Turkey.
Department of Anatomy, Institute of Health Sciences, Ege University, Izmir, Turkey.
World Neurosurg. 2024 Nov;191:e206-e213. doi: 10.1016/j.wneu.2024.08.096. Epub 2024 Aug 22.
The rhomboid fossa (RF) is a crucial anatomical region in brainstem surgery as it contains essential structures such as the reticular formation and cranial nerve nuclei. This study aimed to provide a detailed understanding of the complex microsurgical anatomy of the RF, which is vital for the safe execution of neurosurgical procedures.
Morphometric analysis was conducted on 45 adult human brainstems preserved in 10% formalin. Under 20× magnification, 13 linear measurements were performed using a millimeter graph to identify key anatomical landmarks.
The RF measured 34.65 mm in length and 22.61 mm in width. The facial colliculus measured 4.26 mm in length on the left and 4.45 mm on the right, with corresponding widths of 3.77 mm and 3.50 mm. The distance between the sulcus limitans incisures was 9.52 mm, and the distance from the upper border of the medullary striae to obex was 11.53 mm. The proximity of the facial colliculus to the median sulcus was measured at 0.86 mm on the right and 0.96 mm on the left. Additionally, 2 safe entry zones-the suprafacial and infrafacial triangles-were identified, offering pathways to reach dorsal pons lesions through the RF.
This comprehensive morphometric analysis of the RF enhances the understanding of its intricate anatomy. By describing safe entry zones, the suprafacial and infrafacial triangles, and providing precise measurements of key anatomical features, this study serves as a valuable resource for neurosurgeons in planning and executing brainstem surgeries.
菱形窝（RF）是脑干手术中的一个关键解剖区域，因为它包含诸如网状结构和脑神经核等重要结构。本研究旨在详细了解RF复杂的显微外科解剖结构，这对于安全实施神经外科手术至关重要。
对保存在10%福尔马林中的45个成人大脑脑干进行形态计量分析。在20倍放大倍数下，使用毫米图进行13项线性测量，以确定关键解剖标志。
RF长34.65毫米，宽22.61毫米。面神经丘左侧长4.26毫米，右侧长4.45毫米，相应宽度分别为3.77毫米和3.50毫米。界沟切迹之间的距离为9.52毫米，髓纹上缘至闩的距离为11.53毫米。面神经丘与正中沟的距离右侧为0.86毫米，左侧为0.96毫米。此外，还确定了2个安全进入区——面神经上三角和面神经下三角，为通过RF到达脑桥背侧病变提供了途径。
对RF的这种全面形态计量分析增强了对其复杂解剖结构的理解。通过描述安全进入区、面神经上三角和面神经下三角，并提供关键解剖特征的精确测量值，本研究为神经外科医生规划和实施脑干手术提供了宝贵资源。
