The auricular branch of the vagus nerve is often termed the Alderman's nerve or Arnold's nerve. The latter name is an eponym for

Friedrich Arnold Friedrich Arnold (8 January 1803 – 5 July 1890) was professor emeritus of anatomy and physiology at Heidelberg. He read medicine at the University of Heidelberg at the same time as his elder brother, Johann Wilhelm Arnold (1801–1873). Arno ...

. The auricular branch of the

vagus nerve The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and rig ...

supplies sensory innervation to the skin of the

ear canal The ear canal (external acoustic meatus, external auditory meatus, EAM) is a pathway running from the outer ear to the middle ear. The adult human ear canal extends from the pinna to the eardrum and is about in length and in diameter. Stru ...

, tragus, and auricle.

Path

It arises from the superior ganglion of the vagus nerve, and is joined soon after its origin by a filament from the

petrous ganglion The inferior ganglion of the glossopharyngeal nerve (petrosal ganglion) is a sensory ganglion. It is larger than and inferior to the superior ganglion of the glossopharyngeal nerve. It is located within the jugular foramen. The pseudounipolar n ...

of the

glossopharyngeal The glossopharyngeal nerve (), also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper medulla, just anterior (closer to the nose) to the vagus nerve. Bei ...

; it passes behind the

internal jugular vein The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the post ...

, and enters the mastoid canaliculus on the lateral wall of the jugular fossa. Traversing the substance of the

temporal bone The temporal bones are situated at the sides and base of the skull, and lateral to the temporal lobes of the cerebral cortex. The temporal bones are overlaid by the sides of the head known as the temples, and house the structures of the ears ...

, it crosses the

facial canal The facial canal (''canalis nervi facialis''), also known as the Fallopian canal, is a Z-shaped canal running through the temporal bone of the skull. It runs from the internal acoustic meatus to the stylomastoid foramen. It contains the facial ...

about above the

stylomastoid foramen The stylomastoid foramen is a foramen between the styloid and mastoid processes of the temporal bone of the skull. It is the termination of the facial canal, and transmits the facial nerve, and stylomastoid artery. Facial nerve inflammation in ...

, and here it gives off an ascending branch which joins the

facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of ta ...

. The nerve reaches the surface by passing through the

tympanomastoid fissure The temporal bones are situated at the sides and base of the skull, and lateral to the temporal lobes of the cerebral cortex. The temporal bones are overlaid by the sides of the head known as the temples, and house the structures of the ears. T ...

between the mastoid process and the tympanic part of the temporal bone, and divides into two branches: * one joins the

posterior auricular nerve The posterior auricular nerve is a nerve of the head. It is a branch of the facial nerve (CN VII). It communicates with branches from the vagus nerve, the great auricular nerve, and the lesser occipital nerve. Its auricular branch supplies the po ...

. * the other is distributed to the skin of the back of the

ear An ear is the organ that enables hearing and, in mammals, body balance using the vestibular system. In mammals, the ear is usually described as having three parts—the outer ear, the middle ear and the inner ear. The outer ear consists ...

(auricle) and to the posterior part of the

Clinical significance

This nerve may be involved by the glomus jugulare tumour.

Laryngeal cancer Laryngeal cancers are mostly squamous-cell carcinomas, reflecting their origin from the epithelium of the larynx. Cancer can develop in any part of the larynx. The prognosis is affected by the location of the tumour. For the purposes of stagin ...

can present with pain behind the ear and in the ear - this is a

referred pain Referred pain, also called reflective pain, is pain perceived at a location other than the site of the painful stimulus. An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in t ...

through the vagus nerve to the nerve of Arnold. In a small portion of individuals, the auricular nerve is the afferent limb of the Ear-Cough or Arnold Reflex. Physical stimulation of the external acoustic meatus innervated by the auricular nerve elicits a cough, much like the other cough reflexes associated with the vagus nerve. Rarely, on introduction of speculum in the external ear, patients have experienced syncope due to the stimulation of the auricular branch of the vagus nerve.

Clinical application

This nerve may be stimulated as a diagnostic or therapeutic technique

Transcutaneous vagus nerve stimulation Vagus nerve stimulation (VNS) is a medical treatment that involves delivering electrical impulses to the vagus nerve. It is used as an add-on treatment for certain types of intractable epilepsy and treatment-resistant depression. Medical use VNS ...

(tVNS) was proposed by Ventureya (2000) for seizures. In 2003 Fallgatter et al. published "Far field potentials from the brain stem after transcutaneous vagus nerve stimulation" and in 2007 Kraus et al. did the first tVNS-fMRI study. In Europe, a device was approved for seizure treatment (NEMOS by CerboMed). Although the transcutaneous method has not been specifically approved in the United States (i.e. off-label) it is legal and being investigated (and found to be effective and safe) for many conditions including: * Atrial fibrillation * Depression *

Diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level (hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

Endotoxemia Lipopolysaccharides (LPS) are large molecules consisting of a lipid and a polysaccharide that are bacterial toxins. They are composed of an O-antigen, an outer core, and an inner core all joined by a covalent bond, and are found in the outer m ...

Memory Memory is the faculty of the mind by which data or information is encoded, stored, and retrieved when needed. It is the retention of information over time for the purpose of influencing future action. If past events could not be remembered ...

Myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ...

Tinnitus Tinnitus is the perception of sound when no corresponding external sound is present. Nearly everyone experiences a faint "normal tinnitus" in a completely quiet room; but it is of concern only if it is bothersome, interferes with normal hearin ...

* Stroke

References

External links

Diagram
{{Authority control Vagus nerve Nerves of the head and neck