AUTHOR=Ding Feiyu , Li Pan , Zuo Xiaozhou , Song Wenxiong , Xiao Yong , Wang Dong , Geng Liangyuan , Hu Xinhua , Yang Kun , Liu Yong , Zou Yuanjie TITLE=Case report: Significance of the large rhomboid lip in microvascular decompression: insights from two clinical cases JOURNAL=Frontiers in Neurology VOLUME=14 YEAR=2024 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1336273 DOI=10.3389/fneur.2023.1336273 ISSN=1664-2295 ABSTRACT=

The rhomboid lip (RL) is a layer of neural tissue that extends outside the fourth ventricle and is connected to the lateral recess of the fourth ventricle. Although this anatomical structure has been rigorously studied, it is often overlooked in microvascular decompression (MVD) surgery. In this report, we present two cases, one of hemifacial spasm (HFS) and one of glossopharyngeal neuralgia (GPN), in which a large RL was observed during surgery. We found that a large RL is easily confused with arachnoid cysts, and accurate identification and dissection are important to protect the lower cranial nerves.