Title: The Nerve of Kuntz: Incidence, Location and Variations
Abstract: Nerve of Kuntz is considered to be one of the causes of recurrence of symptoms following endothoracic sympathectomy. This study was designed to explore the anatomic variations in the location and course of the intrathoracic nerve of Kuntz (INK). Bilateral dissection of the sympathetic chain and somatic nerves of the upper 5 intercostal spaces was undertaken in 25 adult cadavers. The total sample size comprised 25 cadavers (50 sides). The incidence of any connection between the first and second thoracic nerves (INK), the diameter of the INK, the distance from the arising point of the INK from the second thoracic nerve to the sympathetic trunk were noted. The presence and/or absence of stellate ganglion, location of second thoracic ganglion, occurrence of any connection from the lower thoracic nerves with the first thoracic nerve, and occurrence of subpleural vein and collateral artery were also recorded. All measurements were made with digital calipers. The intrathoracic nerve of Kuntz was observed in 33 (66%) sides (54.5% left, 45.5% right) and was present bilaterally in 78.9% of 19 cadavers. The diameter of the intrathoracic nerve was 1.32±0.10 mm on the left and 1.29±0.12 mm on right side. The arising point of the intrathoracic nerve from the second thoracic nerve was 9.0±0.06 mm on left side and 1.06±0.06 mm on right side from the sympathetic trunk. In 80% of cases a collateral artery was present in relation to INK. It is concluded that second thoracic nerve contributes fibers to the brachial plexus that do not ascend in sympathetic trunk. These nerve fibers, the Nerve of Kuntz, pass up over the second rib level on their way to join the first thoracic nerve. To achieve successful results of endothoracic sympathectomy it is imperative that all the sympathetic nerve fibers crossing the second rib level should be divided.
Publication Year: 2010
Publication Date: 2010-01-01
Language: en
Type: article
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Cited By Count: 3
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