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. 2021 Nov 25;15:676680. doi: 10.3389/fnins.2021.676680

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Copyright © 2021 Settell, Skubal, Chen, Kasole, Knudsen, Nicolai, Huang, Zhou, Trevathan, Upadhye, Kolluru, Shoffstall, Williams, Suminski, Grill, Pelot, Chen and Ludwig.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Ultrasound method for visualizing the vagus nerve in a representative subject (A) the swine surgical window includes the right vagus nerve (VN) and the carotid artery, as well as the 50 MHz ultrasound probe (US probe) moving in the cranial to caudal direction. Skin, muscle, and fat were retracted in this acute preparation. (B) Representative VN in one of the cadaver subjects showing fiducial wire (green arrow heads) and histology dye as well as cross section of US plane (D). (C) Schematic of the probe direction (gray dashed arrow) as it scanned from the nodose ganglion (NG) (in vivo) or superior cervical ganglion (SCG) (cadaver) moving caudally, approximately 10 cm. (D) Ultrasound cross section demonstrating bimodal fascicular organization within the surgical window, with wire fiducial marker and zoom of nerve indicated with white box (E,F). (E,F) Zoomed region of ultrasound still (white box, D) demonstrating sensory and motor bimodal arrangement (purple and red regions, respectively) as traced from the pseudo-unipolar cell plane of the nodose ganglion (See Supplementary Video, Cadaver Subject 1 for the full ultrasound video) The sympathetic trunk (ST), as traced from the SCG is indicated in yellow (G,H) A representative, paired histology section (5 μm, Gomori’s trichrome) showing the bimodal organization of the vagus nerve within the surgical window, at the wire fiducial marker, indicating the bimodal sensory and motor fascicular organization, as indicated by the purple and red regions, respectively. The ST is indicated in yellow. (I) Subject 1 3D ultrasound data clearly showing the nodose ganglion and superior laryngeal extending ventromedially, and vagal trunk extending in the cranial and caudal direction. The superior cervical ganglion is just cranial to the nodose ganglion, with the sympathetic trunk (ST) running parallel to the vagus nerve along the dorsomedial aspect. (J) Coronal plane (ventral to dorsal) of vagus nerve showing axons extending from the pseudo-unipolar cell plane to the sensory afferent mode of the vagal trunk. In the zoomed region of the vagal trunk, sensory afferent fascicles are indicated by the yellow arrow, and motor efferent fascicles are indicated by the pink arrow.