Probabilistic mapping of the cervical sympathetic trunk ganglia.
The goal of this study was to create a heat map indicating the probabilistic location of major ganglia of the cervical sympathetic trunk (CST). Detailed dissections of human cadaveric specimens, followed by spatial registration and analysis of the cervical sympathetic ganglia in the neck and upper thorax regions (C1-T1) were performed in 104 neck specimens (both sides from 52 cadavers). Unbiased parametric mapping, visualized with a heat map, revealed a general pattern of two major ganglia located on both sides of the neck: The superior cervical ganglion (SCG) was located 80-90 mm superior to the point at which the vertebral artery entered the transverse foramen (VA-TF); the stellate ganglion (SG) was located approximately 10 mm inferior to the VA-TF in 80% of our sample, or surrounding the VA-TF in the remaining 20% of our sample. In between these ganglia, a highly variable number of smaller and less prevalent ganglia were present on either side of the neck. The middle ganglia on the right side of the neck were located closer to the SCG, possibly indicative of the middle cervical ganglion. On the left side the middle ganglia were located closer to the SG, perhaps indicative of the vertebral ganglion or the inferior cervical ganglion. Individual specimens could be classified into one of seven different patterns of cervical trunks. The results may help surgeons and anesthesiologists more accurately target and preserve these structures during medical procedures.
Division of Integrative Anatomy, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
M Elena
ME
Stark
Division of Integrative Anatomy, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Emory Healthcare, Atlanta, GA, United States.
Ilan
I
Safir
Division of Integrative Anatomy, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Physiology and Developmental Biology, Neuroscience Center, Brigham Young University, Provo, UT, United States; Department of Neurobiology and Anatomy, University of Utah Medical School, Salt Lake City, UT, United States. Electronic address: jjwisco@byu.edu.
Jonathan J
JJ
Wisco
D000369:Aged, 80 and over; D063405:Anatomic Variation; D005260:Female; D005728:Ganglia, Sympathetic / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D009333:Neck / Q000294:innervation*; D011336:Probability; D013233:Stellate Ganglion / Q000033:anatomy & histology*; D017783:Superior Cervical Ganglion / Q000033:anatomy & histology*; D013909:Thorax / Q000294:innervation*
Cervical sympathetic trunk; Positional frequency map; Statistical heat map; Sympathetic ganglia