Walsh & Hoyt: Sympathetic Pathway for Lacrimation

As discussed earlier in this chapter, preganglionic sympathetic fibers leave the lateral column of the spinal cord, travel along the cervical sympathetic chain, and synapse in the superior cervical ganglion. The postganglionic fibers join the carotid plexus, enter the base of the skull, and pass to the lacrimal gland by multiple routes. One recognized route goes to the vidian nerve via the deep petrosal nerve. These fibers pass through the sphenopalatine ganglion, join the zygomaticotemporal nerve, and then pass into the lacrimal gland with the parasympathetic motor fibers. Other sympathetic fibers reach the lacrimal gland via the carotid plexus, the ophthalmic division of the trigeminal nerve, and the lacrimal nerve. Still others may reach the gland via the cavernous sinus neural plexus, the ophthalmic artery, and the lacrimal artery.