Jake Gamboa, Brigham Young University
It is estimated that approximately 350,000 people in the United Stated die annually from post-myocardial infarction arrhythmias. A majority of these people will undergo a surgery that results in partial or complete removal of the stellate ganglion and other nerve fibers of the pharyngeal space in an attempt to prevent over stimulation from the neurons to the area of dead heart tissue and, therefore, future arrhythmias. However, without a somatomototopy, it is unclear what physiological effects partial or full sympathectomies may have. We will create a three-dimensional map of the pharyngeal space nerve plexus which will, in turn, allow for a more accurate and precise surgery.
This project is of extreme importance due to the fact that there are currently no data-driven three-dimensional maps of the somatomototopy, or neuronal arrangement, of the cervical plexus in the pharyngeal space. This knowledge would be very practical for post-infarction surgery. In our studies of cervical sympathetic chain ganglia distribution in the parapharyngeal space, we have noted numerous branching patterns of nerves between ganglia, but lacked an adequate means by which to record our observations. We will utilize MicroScribe 3D digitization technology to map detailed observations of a parapharyngeal plexus. After careful dissection of the parapharyngeal spaces on the left and right side in a human cadaveric specimen (56-year-old male), we will digitize pathways of the cervical sympathetic chain, including branches contributing to the cardiac nerves. Through the Autodesk Maya animation program, we will reconstruct the fiber tracings to 3D images, enhanced by caliper-recorded nerve caliber measurements. This procedure will innovate future methods to obtain data driven visualizations of nerve branches and pathways. It will also be an invaluable resource for correlative studies to the location of the infarction to corresponding area of the nerve fibers, as well as for innovative pre-surgical planning.