I find that Kuntz nerves (small branches off of the main sympathetic nerve trunk) are present at the T2, T3, T4 (2nd/3rd/4th thoracic levels) in 85 to 90% of patients from around the world. There doesn't seem to be a gender or race predilection for Kuntz nerves. In my recent examination of 100 consecutive patients from around the world undergoing Micro ETS, I found that 88 out of the 100 patients had Kuntz nerves. Of the 88 patients that had Kuntz nerves, the average number of Kuntz nerves per patient was 3.73 with a range of 1 to 9.

The diameter of Kuntz nerves ranged from 0.3 to 2.5 mm with the most common diameter of 0.9 to 1.0 mm. Forty three of these patients with Kuntz nerves were female and forty five were male. Of the 12 patients that didn't have any Kuntz nerves, 5 were female and 7 were male.

Kuntz nerves are small branches of sympathetic nerve that arise from a ganglion anywhere from one to several levels caudally (lower down on the sympathetic nerve chain). These Kuntz nerves then travel in a cranial direction (towards the head) running parallel or at divergent angles away from the main sympathetic nerve as they travel in this cephalad direction.

Kuntz nerves that arise from T4 can actually cross the second rib several inches lateral to the mainsympathetic nerve trunk, making them easily missed especially if not examined from an optimized angle and if the surgeon's technique is one where only very large Kuntz nerves can be seen. In instances such as these, the incidence of finding Kuntz nerves is reportedly as low as 5 to 20%.