Surgical interventions involving the sympathetic trunk are increasingly performed to alleviate symptoms of several disorders such as hyperhidrosis. Anatomical variation has been highlighted as one of the main causes behind surgical failure and symptoms recurrence following surgeries conducted on the chain or its surroundings. This study therefore aimed to record anatomical variants within spinal segments C8-T10 of the sympathetic trunk. Thirty Thiel-embalmed cadavers were investigated bilaterally. The stellate ganglion was recorded on 29 sides. Its size was significantly greater in males and on the right side when the coalescence extended to the subsequent ganglion. The intrathoracic nerve of Kuntz was observed on 21 sides and was significantly more prevalent in males. There was a significant positive association between the presence of this nerve and the descending ramus in the first intercostal space. Aberrant rami found between spinal root C8 and the ventral ramus of the first intercostal nerve were introduced as rami communicantes superi. Aberrant rami communicantes were recorded 50 times in total, of which 70% were found in males. Descending rami showed the highest prevalence in upper intercostal levels, especially in males within the first intercostal space. Aberrant neuronal pathways in upper levels were significantly more prevalent when the stellate ganglion was present. The scientific literature has proven to be stochastic as results were significantly higher in past studies in regard to some sympathetic variants. Anatomical findings of the current study as well as the inconsistency of previous data should be acknowledged and considered for better surgical planning.
AbbreviationsSRcRami communicantes superi
SIRIntrathoracic Ramus/Rami superi
SARAscending Ramus/Rami superi
SDRDescending Ramus/Rami superi
IRIntrathoracic Ramus/Rami
SGStellate Ganglion/Ganglia
INKIntrathoracic Nerve(s) of Kuntz
ICGInferior Cervical Ganglion/Ganglia
ANSAutonomic Nervous System
GSGreater Splanchnic (nerve)
ETSEndoscopic Thoracic Sympathectomy
TSEThiel Soft-Fix Embalming
DAPDistal Attachment Point
T1First Thoracic Ganglion (applies to all thoracic ganglia)
1ICFirst Intercostal nerve (applies to all intercostal nerves)
KeywordsSympathetic trunk
Stellate ganglion
Kuntz nerve
Variation
Surgical failure
Thiel
© 2022 The Author(s). Published by Elsevier GmbH.
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