Cervico-thoracic ganglion: Its clinical implications
Cervico-thoracic ganglion: Its clinical implications
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DOI：
10.1002/ca.20214
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发表时间：
2006-05-01
期刊：
影响因子：
2.4
通讯作者：
Satyapal, KS
中科院分区：
文献类型：
--
作者：
Pather, N;Partab, P;Satyapal, KS
颈胸神经节（CTG）的病变导致通向头部、颈部、上肢和胸脏器的交感神经纤维中断。对CTG解剖结构的准确理解与交感神经切除术有关，在常规干预失败的情况下，交感神经切除术可能会被规定。本研究记录CTG的发生率和分布，以避免潜在的并发症，如荷马综合征和心律失常。本研究利用48具尸体，共解剖了89条交感神经链。75例（84.3%）颈下神经节与胸第一神经节融合形成CTG。其中48例（65.3%）呈双侧病变。CTG有主轴形、哑铃形和倒“L”形三种不同形状。哑铃形和倒“L”形显示明确的“腰”（即宏观可见的ICG和CTG T1组成部分的结合）。CTG的Rami分布于臂丛、锁骨下动脉和椎动脉、头臂干和心丛。本研究表明CTG引起的双心交感神经发生率高。因此，在交感神经切除术技术中，对于顽固性心绞痛，外科医生切除这两个分支，但不破坏神经节本身是必要的。内窥镜手术技术的不断进步，使得研究交感神经链解剖结构的细微差别变得至关重要。
Lesions of the cervicothoracic ganglion (CTG) result in interruption of sympathetic fibers to the head, neck, upper limb, and thoracic viscera. The accurate understanding of the anatomy of the CTG is relevant to sympathectomy procedures that may be prescribed in cases where conventional intervention has failed. This study documents the incidence and distribution of the CTG to avoid potential complications such as Homer's syndrome and cardiac arrhythmias. This study utilized 48 cadavers, in which a total of 89 sympathetic chains were dissected. The inferior cervical ganglion (ICG) and the first thoracic ganglion was fused in 75 cases (84.3%) to form the CTG. It was present bilaterally in 48 of these specimens (65.3%). Three different shapes of CTG were differentiated, viz. spindle, dumbbell, and an inverted "L" shape. The dumbbell and inverted "L" shapes demonstrated a definite "waist" (i.e., a macroscopically visible union of the ICG and T1 components of the CTG). Rami from the CTG was distributed to the brachial plexus, the subclavian and vertebral arteries, the brachiocephalic trunk, and the cardiac plexus. This study demonstrates a high incidence of a double cardiac sympathetic nerve arising from CTG. It is therefore imperative that in the technique of sympathectomy, for intractable anginal pain, the surgeon excises both these rami but does not destroy the ganglion itself. The ever-improving technology in endoscopic surgery has made investigations into the nuances of the anatomy of the sympathetic chain essential.