Anatomic variations of the T2 nerve root (including the nerve of Kuntz) and their implications for sympathectomy.
OBJECTIVE
The aim of this study was to clarify the anatomic variations of the intrathoracic nerve of Kuntz, and this should help delineate the resection margins during video-assisted thoracic sympathectomy.


METHODS
Sixty-six thoracic sympathetic chains of 39 adult Korean cadavers were dissected on both sides of the thorax in 27 cadavers (54 sides) and on one side in 12 cadavers (12 sides).


RESULTS
The intrathoracic nerve was observed in 45 (68.2%) sides and was present bilaterally in 48.1% of cadavers. No intrathoracic nerve or ascending ramus communicans arising from the second thoracic nerve was observed in only 5 (7.6%) sides. The diameter of the intrathoracic nerve was 1.25 plus minus 0.55 mm on average. The arising point of the intrathoracic nerve from the second thoracic nerve was 7.3 mm on average from the sympathetic trunk. Presence of the stellate ganglion was noted in 56 (84.8%) sides, and 6 (9.1%) sides showed a single large ganglion formed by the stellate and the second thoracic sympathetic ganglia. The second thoracic sympathetic ganglion was most commonly located (50%) in the second intercostal space.


CONCLUSIONS
The anatomic variations of the intrathoracic nerve of Kuntz and the second thoracic sympathetic ganglion were characterized in human cadavers. It is hoped that this study will help to improve the recurrence of symptoms caused by the intrathoracic nerve in an upper thoracic sympathectomy for hyperhidrosis.
Chung
In-Hyuk
IH
Department of Anatomy, Yonsei University College of Medicine, Seodaemoonku Shinchondong 134, Seoul 120-754, Korea. chinhy@yumc.yonsei.ac.kr
Oh
Chang-Seok
CS
Koh
Ki-Seok
KS
Kim
Hee-Jin
HJ
Paik
Hyo-Chae
HC
Lee
Doo-Yun
DY
D005260:Female; D005728:Ganglia, Sympathetic / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D013562:Sympathectomy; D020775:Thoracic Surgery, Video-Assisted; D013909:Thorax / Q000294:innervation*