Bermejo P, López M, Larraya I, Chamorro J, Cobo J L, Ordóñez S, Vega J A
Walden Medical Neuro Digital Therapies S.L., Gijón, Spain.
Servicio de Cirugía Máxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Morfología y Biología Celular, Grupo SINPOs, Universidad de Oviedo, Oviedo, Spain.
Biomed Res Int. 2017;2017:7830919. doi: 10.1155/2017/7830919. Epub 2017 Mar 15.
The innocuous transcutaneous stimulation of nerves supplying the outer ear has been demonstrated to be as effective as the invasive direct stimulation of the vagus nerve for the treatment of some neurological and nonneurological disturbances. Thus, the precise knowledge of external ear innervation is of maximal interest for the design of transcutaneous auricular nerve stimulation devices. We analyzed eleven outer ears, and the innervation was assessed by Masson's trichrome staining, immunohistochemistry, or immunofluorescence (neurofilaments, S100 protein, and myelin-basic protein). In both the cavum conchae and the auditory canal, nerve profiles were identified between the cartilage and the skin and out of the cartilage. The density of nerves and of myelinated nerve fibers was higher out of the cartilage and in the auditory canal with respect to the cavum conchae. Moreover, the nerves were more numerous in the superior and posterior-inferior than in the anterior-inferior segments of the auditory canal. The present study established a precise nerve map of the human cavum conchae and the cartilaginous segment of the auditory canal demonstrating regional differences in the pattern of innervation of the human outer ear. These results may provide additional neuroanatomical basis for the accurate design of auricular transcutaneous nerve stimulation devices.
已证明，对外耳神经进行无害的经皮刺激在治疗某些神经和非神经紊乱方面与迷走神经的侵入性直接刺激同样有效。因此，精确了解外耳的神经支配情况对于设计经皮耳神经刺激装置极为重要。我们分析了11只外耳，并通过Masson三色染色、免疫组织化学或免疫荧光（神经丝、S100蛋白和髓鞘碱性蛋白）评估神经支配情况。在耳甲腔和耳道中，均在软骨与皮肤之间以及软骨外发现了神经束。相对于耳甲腔，软骨外和耳道中的神经束以及有髓神经纤维的密度更高。此外，耳道上半部分和后下部分的神经比前下部分更多。本研究建立了人类耳甲腔和耳道软骨段的精确神经图谱，显示了人类外耳神经支配模式的区域差异。这些结果可为精确设计耳经皮神经刺激装置提供额外的神经解剖学依据。
