Corpus: Cervicothoracic ganglion
1. Definition
The cervicothoracic ganglion, also known as the stellate ganglion, is formed by the fusion of the inferior cervical ganglion with the first thoracic ganglion. In rare cases, the second or even third thoracic ganglion may also be included in this fusion.
2. Anatomy
2.1. Morphology
The cervicothoracic ganglion is relatively large compared to other paravertebral ganglia, measuring approximately 10 to 12 mm in width and 8 to 20 mm in length. It has a polygonal shape with star-shaped extensions, giving it a distinctive appearance.
2.2. Topography
The cervicothoracic ganglion is located at the level of the seventh cervical vertebra, anterior to the head of the first rib and posterior to the pleural dome. It is situated between the vertebral artery and the common carotid artery, with the subclavian artery positioned cranially, the longus colli muscle medially, and the scalene muscles laterally. The ganglion is covered by the prevertebral layer of the cervical fascia.
2.3. Nerve branches
The cervicothoracic ganglion is connected to the spinal nerves of segments C7, C8, and T1, and sometimes also to C5 and C6, through communicating branches. It plays a crucial role in the sympathetic innervation of the upper extremities, head, and neck.
3. Clinic
The targeted elimination of the cervicothoracic ganglion using local anesthetics is known as a cervicothoracic blockade. This procedure is indicated for conditions such as Raynaud's disease, complex regional pain syndrome (CRPS), migraine, or hyperhidrosis of the hands. The blockade leads to vasodilation, reduced sweat secretion, and the development of Horner's syndrome in the areas supplied by the affected nerve fibers.