The Rhomboid Lip: Anatomy, Pathology, and Clinical Consideration in Neurosurgery

Abstract

Objective: To describe microsurgical anatomy of the rhomboid lip (RL) and to consider its role by presenting histology and clinical cases.

Methods: We examined 10 (20 sides) formalin-fixed adult human cadaveric heads injected with colored silicone. A total of 20 RLs were examined posteriorly. We examined the expansion of the RL in the cerebellopontine cistern. We assessed the relationship between the RL and choroid plexus and the RL and cranial nerve IX and classified the RL. We also observed these relationships in clinical cases during surgeries and examined histologic assessments of the RL.

Results: The RL was divided into 3 types, non-extension type, lateral extension type, and jugular foramen type, according to the relationship between the RL and choroid plexus. There were many variations of the extension of the RL. The jugular foramen type was rare.

Conclusions: Histologically, the RL is the remnant of the fourth ventricle covered with ependymal cells. Knowledge of the detailed anatomy and proper dissection of the RL may help surgeons to obtain good visualization of structures around the foramen of Luschka.

Keywords: Lateral recess; Lower cranial nerves; Microvascular decompression; Rhomboid lip.