Morphology of Perforated Cervicothoracic Ganglion in Indian Cadavers

Abstract

Background: Cervicothoracic ganglion (CTG) has surgical significance for the diagnosis and treatment of chronic regional pain syndromes, herpes zoster, refractory angina, vascular occlusive disorders, etc. Rarely, CTG could be perforated by the vertebral artery (VA), which might lead to complications during the ganglionic block. The present study describes the morphology of perforated CTG in Indian cadavers. Methodology: The present study included 25 formalin-embalmed cadavers (male – 18, female – 7) that were utilized for undergraduate teaching in the department of anatomy from 2017 to 2021. Out of 25 cadavers, two specimens on the right side were excluded from the study due to adhesion and damage to the ganglion. A total of 48 specimens (right – 23; left – 25) were included in the study and analyzed for the perforated CTG. Results: CTG was observed in 87.5% of the specimens and the inferior cervical ganglion in 12.5%. Perforated CTG was observed in four specimens (9.52%) exclusively on the left where the VA pierced at its superior pole or middle. The perforated CTG was found exclusively on the left, and in all four specimens, the VA was a branch from the subclavian artery. Conclusion: An analysis of the morphology of perforated CTG in Indian cadavers revealed its significant occurrence in the present study. It is crucial to consider the risk of injuring the VA during a CTG block. Understanding this variation could aid anesthetists, neurosurgeons, and surgeons in preventing complications during the therapeutic and diagnostic ganglionic blocks.

Keywords

• inferior cervical ganglion
• stellate ganglion
• sympathetic chain
• vertebral artery