Auricular branch of vagus nerve

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.^[1] The auricular branch of the vagus nerve supplies sensory innervation to the skin of the ear canal, tragus, and auricle.

Path

It arises from the

Traversing the substance of the temporal bone, it crosses the facial canal about 4 mm (0.16 in) above the stylomastoid foramen, and here it gives off an ascending branch which joins the facial nerve.

The nerve reaches the surface by passing through the

• one joins the posterior auricular nerve.
• the other is distributed to the skin of the back of the
  ear (auricle) and to the posterior part of the ear canal
  .

This nerve may be involved by the glomus jugulare tumour.

Laryngeal cancer 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.^[2] 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

• Atrial fibrillation^[6][7]
• Depression^[8][9]
• Diabetes^[10]
• Endotoxemia^[11]
• Memory^[12]
• Myocardial infarction^[13]
• Tinnitus^[14]
• Stroke^[15]

References

This article incorporates text in the public domain from page 911 of the 20th edition of Gray's Anatomy (1918)