VARIABILITY AND BILATERAL ASYMMETRY THE CERVICAL PART OF THE SYMPATHETIC TRUNK IN HUMAN FETUSES

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The development of fetal surgery determines the relevance of studying fetal anatomy, particularly the topography of the nodes of the sympathetic trunk of the neck. Details of the location of the nodes and their connections with the surrounding nerves and vessels are critically important for the successful conduct of operations, reducing the risks of complications and increasing the effectiveness of surgical interventions. Objective. To determine the macroscopic structure and topography of the cervical part of the sympathetic trunk, in particular its ganglions, connecting branches, and their connections with the nodes and nerve plexuses of the thoracic department of the sympathetic trunk. Material and methods. Macromicroscopic preparation under a falling drop of water and injection of venous vessels of 12 preparations of human fetuses of different ages 81.0-375.0 mm parietal-coccygeal length (PCL). Results. In the studied human fetuses, the cervical part of the sympathetic trunk is covered by the prevertebral fascia, located on the prevertebral muscles, primarily the longus muscle of the neck. The superior and middle cervical ganglions mainly represent it. It should be noted that the number of cervical nodes of the sympathetic trunk varies from 2 to 4. The superior cervical ganglion, which is permanent, usually has a spindle-shaped or oval shape and is located at the base of the skull. An approximate triangular shape mainly characterizes the middle cervical ganglion and is unstable. As an independent formation, the inferior cervical ganglion was detected in 4 observations. Conclusions. Asymmetry and variability of the shape and topography of all components of the cervical part of the right and left sympathetic trunks were noted. The middle cervical ganglion is unstable. The subclavian loop was detected in all observations. In the studied fetuses, bilateral asymmetry of the place of origin and the number of connecting branches of the cervical sympathetic trunk was established. Variability in the number, structure, and topography of internodal branches was revealed depending on the structure of the sympathetic trunk. The formation of the cervical-thoracic vegetative plexus was described. The main collector for the superior cervical ganglion is the pharyngeal vein; for the middle cervical and spinal ganglions – the inferior thyroid vein; for the stellate ganglion – the superior intercostal vein.