A medical student coughs repeatedly while the resident irrigates her external auditory canal during a cerumen removal procedure. Which nerve, passing through the tympanomastoid fissure to supply the concha and posterior auricular skin, mediates this reflex?
- A Auricular branch of the vagus nerve (nerve of Arnold) ✓
- B Auriculotemporal nerve
- C Great auricular nerve
- D Lesser occipital nerve
Correct answer: A. Auricular branch of the vagus nerve (nerve of Arnold)
Explanation
The auricular branch of the vagus (Arnold's nerve) supplies the concha, cymba conchae and posterior canal wall, and stimulation during syringing triggers the ear-cough (Arnold) reflex. The auriculotemporal nerve supplies the tragus, antitragus and anterior canal wall but does not mediate this reflex. The great auricular nerve supplies the lobule and lower lateral auricle, so it is the best distractor but anatomically separate.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.