Unusual pattern of branches and ganglions of cervical sympathetic trunk- single case study with clinical implications

During routine dissection for didactic purposes, we found unusual branching pattern of cervical sympathetic trunk. In our case cervical sympathetic trunk had not only superior, middle, and inferior ganglia, but also presented two more ganglia in its main course. One of accessory ganglia was identified to be vertebral ganglion and presented with vertebral loop. All three cardiac cervical nerves emerged from another, extravertebral ganglion, which was supplied from sympathetic trunk. We are convinced that variability of cervical sympathetic trunk is clinically significant in surgery of head, neck, and cervical spine as well as in anatomy education. Therefore, we present our case showing a possible variation of this structure.