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 righ ...

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 (anatomy), pinna to the eardrum and is about in length and in di ...

, 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 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. B ...

; 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 poste ...

, and enters the

mastoid canaliculus In the lateral part of the jugular fossa of the temporal bone is the mastoid canaliculus for the entrance of 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 ...

on the lateral wall of the

jugular fossa The jugular fossa is a deep depression in the inferior part of the temporal bone at the base of the skull. It lodges the bulb of the internal jugular vein. Structure The jugular fossa is located in the temporal bone, posterior to the carotid can ...

. 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 about above the stylomastoid foramen, 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 taste ...

. The nerve reaches the surface by passing through the tympanomastoid fissure 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 th ...

. * the other is distributed to the skin of the back of the ear (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 staging ...

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

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 remember ...

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 ma ...

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 A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...

References

External links

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