Topographical study of the connections of the rami communicantes from the first to the fifth thoracic sympathetic ganglia

Won, Hyung Jin; Lee, Jong Eun; Lee, Won Taek; Won, Hyung‐Sun

doi:10.1002/ca.23218

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…There are numerous descriptions in the literature of anatomic variations of the intrathoracic nerve and the RCs (Cho et al, 2005; Chung et al, 2002; Marhold et al, 2008; Singh et al, 2005; Won et al, 2018; Zhang et al, 2009), but there are few reports in the types of neural connections of the upper thoracic sympathetic ganglia to the brachial plexus. Zhang et al (2009) postulated that the postganglionic sympathetic fibers of T3G connected to T1 via the second and first intrathoracic nerves, and suggested this as a potential cause for failed sympathetic surgery.…”

Section: Discussionmentioning

confidence: 99%

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Anatomic variations of the intrathoracic nerves and the neural connections of the second and third thoracic sympathetic ganglia to the brachial plexus

2020

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Introduction This study investigated morphological variations of the intrathoracic nerves and the neural connections of the second and third thoracic sympathetic ganglia to the brachial plexus based on the existence of the intrathoracic nerves and the rami communicantes. Materials and methods Fifty thoracic sympathetic trunks from 26 Korean adult cadavers were used. Results The first intrathoracic nerve connecting the first and second thoracic nerves was observed on 36 sides (72%), and the second intrathoracic nerve connecting the second and third thoracic nerves was found on three sides (6%). There were either one (62%) or two (10%) first intrathoracic nerves, and only one second intrathoracic nerve (6%). The neural connections of the second and third thoracic sympathetic ganglia to the first thoracic nerve were classified into three types based on the existence of the intrathoracic nerves: Type I (68%) had only the first intrathoracic nerve, Type II (26%) had no intrathoracic nerve, and Type III (6%) had both the first and second intrathoracic nerves. Types I, II, and III were further subdivided into 10, 6, and 3 types, respectively, according to the types of the rami communicantes arising from the second and third thoracic sympathetic ganglia. Conclusions Improved knowledge of the variations in intrathoracic nerves and upper thoracic sympathetic ganglia will be helpful to thoracic surgeons when they are disrupting the sympathetic supply to the hand for treating palmar hyperhidrosis, and contribute to successful diagnoses and treatments.

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Section: Discussionmentioning

confidence: 99%

“…However, an intrathoracic nerve connecting the second (T2) and third (T3) or the third (T3) and fourth thoracic nerves (T4) has also been reported, with differing descriptions in the literature (Table 1). In addition, an ascending RC running posterior to the rib was found in the upper thoracic region (Won, Lee, Lee, & Won, 2018).…”

Section: Introductionmentioning

confidence: 99%

Anatomic variations of the intrathoracic nerves and the neural connections of the second and third thoracic sympathetic ganglia to the brachial plexus

2020

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“…In sum, our findings elucidate ectopic sympathetic neurons in the ventral root of the human spinal cord. Such findings are important for better understanding of the variations of the human nervous system [30][31][32][33].…”

Section: Clinical Relevancementioning

confidence: 94%

Ectopic sympathetic ganglia cells of the ventral root of the spinal cord: an anatomical study

et al. 2020

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The sympathetic trunk ganglia contain the cell bodies of neurons. However, some patients who undergo sympathectomy can develop compensatory hyperhidrosis. To evaluate for ectopic pathways, the present anatomical study was performed. Ten adult cadavers underwent dissection of the spinal canal and removal of randomly selected ventral roots, which were submitted for histological analysis. Random ventral root samples were taken from cervical, thoracic, and lumbosacral regions in each specimen. Each histological section was then analyzed and the presence or absence of sympathetic cells documented for level and position within the ventral root. Of all samples, a sympathetic nerve cell was found in 80% of ventral roots. At least one sympathetic cell was found in these 80%. Most sympathetic cells were found in the proximal one-third of the ventral root. Such cells were found at all spinal levels and no specific level within a vertebral region was found to house a greater concentration of these cells. No statistical significance was found when comparing sides or sex. Our study confirmed that sympathetic cells exist in the majority of human ventral roots. Such data might better explain various clinical presentations and postoperative complications/findings.

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Anatomical study with clinical significance of communicating and visceral branching of the cervical and upper thoracic sympathetic trunk

Franco‐Riveros,

Pividori,

Martin

et al. 2024

Clinical Anatomy

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Current advances in the management of the autonomic nervous system in various cardiovascular diseases, and in treatments for pain or sympathetic disturbances in the head, neck, or upper limbs, necessitate a thorough understanding of the anatomy of the cervicothoracic sympathetic trunk. Our objective was to enhance our understanding of the origin and distribution of communicating branches and visceral cervicothoracic sympathetic nerves in human fetuses. This was achieved through a comprehensive topographic systematization of the branching patterns observed in the cervical and upper thoracic ganglia, along with the distribution of communicating branches to each cervical spinal nerve. We conducted detailed sub‐macroscopic dissections of the cervical and thoracic regions in 20 human fetuses (40 sides). The superior and cervicothoracic ganglia were identified as the cervical sympathetic ganglia that provided the most communicating branches on both sides. The middle and accessory cervical ganglia contributed the fewest branches, with no significant differences between the right and left sides. The cervicothoracic ganglion supplied sympathetic branches to the greatest number of spinal nerves, spanning from C5 to T2. The distribution of communicating branches to spinal nerves was non‐uniform. Notably, C3, C4, and C5 received the fewest branches, and more than half of the specimens showed no sympathetic connections. C1 and C2 received sympathetic connections exclusively from the superior ganglion. Spinal nerves that received more branches often did so from multiple ganglia. The vertebral nerve provided deep communicating branches primarily to C6, with lesser contributions to C7, C5, and C8. The vagus nerve stood out as the cranial nerve with the most direct sympathetic connections. The autonomic branching pattern and connections of the cervicothoracic sympathetic trunk are significantly variable in the fetus. A comprehensive understanding of the anatomy of the cervical and upper thoracic sympathetic trunk and its branches is valuable during autonomic interventions and neuromodulation. This knowledge is particularly relevant for addressing various autonomic cardiac diseases and for treating pain and vascular dysfunction in the head, neck, and upper limbs.

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Topographical study of the connections of the rami communicantes from the first to the fifth thoracic sympathetic ganglia

Cited by 7 publications

References 16 publications

Anatomic variations of the intrathoracic nerves and the neural connections of the second and third thoracic sympathetic ganglia to the brachial plexus

Anatomic variations of the intrathoracic nerves and the neural connections of the second and third thoracic sympathetic ganglia to the brachial plexus

Ectopic sympathetic ganglia cells of the ventral root of the spinal cord: an anatomical study

Anatomical study with clinical significance of communicating and visceral branching of the cervical and upper thoracic sympathetic trunk

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