Anatomy of the Auricular Branch of the Vagus Nerve
- Arises from the superior ganglion of the vagus nerve
- Joined by a filament from the petrous ganglion of the glossopharyngeal nerve
- Passes behind the internal jugular vein
- Enters the mastoid canaliculus on the lateral wall of the jugular fossa
- Crosses the facial canal about 4mm above the stylomastoid foramen

Distribution of the Auricular Branch of the Vagus Nerve
- Gives off an ascending branch that joins the facial nerve
- Reaches the surface by passing through the tympanomastoid fissure
- Divides into two branches
- One branch joins the posterior auricular nerve
- The other branch is distributed to the skin of the back of the ear and the posterior part of the ear canal

Clinical Significance of the Auricular Branch of the Vagus Nerve
- May be involved by the glomus jugulare tumor
- Laryngeal cancer can cause referred pain behind the ear and in the ear
- Auricular nerve is the afferent limb of the Ear-Cough or Arnold Reflex in some individuals
- Stimulation of the auricular branch can elicit a cough reflex
- Stimulation of the auricular branch during ear examination can cause syncope

Clinical Application of the Auricular Branch of the Vagus Nerve
- Transcutaneous vagus nerve stimulation (tVNS) used for seizures
- tVNS shown to have far field potentials from the brain stem
- tVNS-fMRI studies conducted for various conditions
- tVNS approved in Europe for seizure treatment
- tVNS investigated for conditions like atrial fibrillation, depression, diabetes, and stroke

References
- Grays Anatomy, 20th edition, page 911
- Brendan J. Canning's article on the Anatomy and Neurophysiology of the Cough Reflex
- Ventureyra EC's proposal of transcutaneous vagus nerve stimulation for seizures
- Fallgatter et al.'s publication on far field potentials from the brain stem after tVNS
- Kraus et al.'s tVNS-fMRI study

Auricular branch of vagus nerve (Wikipedia)

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

Auricular branch of vagus nerve
Plan of upper portions of glossopharyngeal, vagus, and accessory nerves (auricular labeled at top center)
Details
From	vagus nerve
Identifiers
Latin	Ramus auricularis nervi vagi
TA98	A14.2.01.156
TA2	6335
FMA	6232
Anatomical terms of neuroanatomy [edit on Wikidata]