ABVN

Definition

The only peripheral branch of the vagus nerve accessible through the outer ear. Its consistent presence in the cymba conchae — a small hollow in the upper outer ear — is what makes non-invasive, ear-based vagus nerve stimulation anatomically possible.

Anatomy and clinical relevance

The ABVN travels through the outer ear, where it innervates parts of the auricle (external ear). Anatomical studies have found it reliably present in the cymba conchae, while its coverage of other auricular regions — including the tragus — is more variable. This distinction is clinically relevant: stimulating the cymba conchae is more likely to engage vagal nerve fibers than other ear sites.

Signals picked up by the ABVN travel toward the brainstem, where they are processed in the superior vagal ganglion and in the nucleus tractus solitarius (NTS) — the main relay station for vagal input. This pathway is the anatomical basis for transcutaneous auricular vagus nerve stimulation (taVNS).

Reviewed by

Ulf Andersson

Professor of Pediatric Rheumatology, Karolinska Institutet

Worked at Karolinska for five decades as a clinician and a basic scientist focusing on inflammation. Co-discoverer of HMGB1 as the prototype alarmin molecule. Honorary doctor at Hofstra University in New York. Highly Cited Clarivate Researcher Web of Science awards.

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