• Mete Erturk, Ibrahim Demircubuk, Esra Candar, and Gulgun Sengul.
• Department of Anatomy, School of Medicine, Ege University, Izmir, Turkey.
• World Neurosurg. 2024 Aug 22.

BackgroundThe 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.MethodsMorphometric 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.ResultsThe 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.ConclusionsThis 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.Copyright © 2024 Elsevier Inc. All rights reserved.

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