BACKGROUND: Stimulation of the nonauditory nervous systems via the trigeminal nerve pathways can be a promising intervention for patients with tinnitus refractory to medical, conservative, and other treatment options. Therapy of the mandibular division of the trigeminal nerve through the auriculotemporal nerve has been reported as useful for patients with tinnitus.
OBJECTIVE: The objective of our study was to study the long-term effects of pulsed radiofrequency of the auriculotemporal nerve in a large group of tinnitus sufferers and to find predictors for a prosperous result.
METHODS: A monocenter backward-looking group study.
RESULTS: In a two-year period, 67 tinnitus patients had pulsed radiofrequency of the auriculotemporal nerve. Twentythree (35%) reported reduced tinnitus loudness at the 7-week post-treatment follow-up. These patients valued the improvements as: 61% good, 22% moderate, and 17% slight. In 3% of patients, tinnitus magnified after the treatment. The odds of permanent tinnitus relief after successful pulsed radiofrequency of the auriculotemporal nerve are 68% at 1 year postoperative. In tinnitus patients without cervical pain 62% had an improvement following pulsed radiofrequency of the auriculotemporal nerve compared to 28% in those not fulfilling this criterion (p=0.024).
CONCLUSIONS: Neuromodulation of the auriculotemporal nerve is an uncomplicated remedy for tinnitus. In a select group of tinnitus patients this treatment can a good relief of their tinnitus for a long period. Especially, tinnitus sufferers without cervical pain will benefit of this therapy.

Communications between cranial nerves or their branches have been described previously. The exact functional significance of some of these neural communications remains to be fully understood. This paper reports a unique communication between the auriculotemporal and inferior alveolar nerves within the infratemporal fossa. The histological examination indicates an antegrade connection from the inferior alveolar nerve to the auriculotemporal nerve, which could potentially be implicated in referred pain from the anatomical territory of one nerve to the other.

This case study describes anatomical variations in the branching pattern of the posterior division of the trigeminal nerve and its clinical implications for dental and craniofacial surgery. The study presents two uncommon variations observed in an elderly male cadaver. A communicating branch connecting one of three roots of the auriculotemporal nerve and inferior alveolar nerve just before entering the mandibular foramen on the right side, and three communicating branches between the IAN and lingual nerve on the left side. The presence of such variations may complicate anesthesia associated with oral surgery procedures.

The auriculotemporal nerve is one branch of the mandibular portion of the trigeminal nerve, which itself divides into several branches in the temporal and retromandibular regions. The lesser occipital nerve is a cutaneous branch of the cervical plexus and is sometimes implicated in cases of cervicogenic headaches, occipitoparietal headaches, and occipital neuralgia, in general. Here, we present a case of unilateral neural interconnection between the auriculotemporal and lesser occipital nerves thus illustrating the joining of the cervical plexus and trigeminal nerve. A better understanding of the aforementioned nervous anatomy may be valuable for facial reconstructive and nerve transfer procedures, as well as for a variety of other head and neck disorders, e.g., occipital neuralgia.

UNASSIGNED: Regional techniques in parotid surgeries include superficial cervical plexus block (SCPB) and auriculotemporal nerve (ATN) block, which can be used as an anesthetic technique for awake parotidectomy. This study aimed to evaluate the efficacy of cervical retrolaminar block (RLB) as an alternative to SCPB both, used in combination with auriculotemporal nerve (ATN) block, in parotid surgery.
UNASSIGNED: A total of 40 patients undergoing parotid surgery were prospectively randomized into either the SCPB group (n = 20) or the cervical RLB group (n = 20) using 20 ml of 0.25% bupivacaine plus 5 mcg\\mL epinephrine. Both were combined with ATN block using 5 ml of 0.25% bupivacaine plus 5 mcg\\mL epinephrine.
UNASSIGNED: The time to first request for analgesia was longer in the RLB group than the SCPB group. Total intra operative fentanyl consumption and post-operative pethidine consumption in the first 24h were lower in group RLB. All patients (n = 20) in the SCPB group required rescue analgesia using pethidine, while only 40% of patients required pethidine in the RLB group. Visual analog scale was lower in the RLB group from 2 to 24-h post-operatively, but it was associated with hypotension and longer block technique time occurred with RLB than SCPB. There was no significant difference in side effects except for 20% Horner\'s syndrome in the SCPB group.
UNASSIGNED: Cervical RLB is more effective analgesic technique than SCPB, as the cervical RLB showed longer time to first analgesic request, lower intraoperative anesthetic consumption, lower total post-operative pethidine consumption and lower VAS.

Venous fenestrations are rare and when present often are not pierced by regional nerves. Herein, we report an unusual case of a fenestrated superficial temporal vein (STV). Anterior to the external ear, where the STV and superficial temporal artery normally travel with the auriculotemporal nerve (ATN), the nerve was found to pierce the STV. The fenestration within the STV was approximately 0.35mm in diameter, and there was no sign of compression of the ATN as it traversed this vessel. Following the site of penetration of the STV by the ATN, the nerve had a normal course into the skin and surrounding fascia. To our knowledge, this is the first report of a fenestrated STV being pierced by the ATN. Such an anatomical variation might be considered by clinicians who treat patients with pathology of this region.

OBJECTIVE: Frey\'s syndrome (FS) describes the phenomenon of gustatory sweating and is a cause of significant social embarrassment for sufferers. It has been attributed to aberrant growth of parasympathetic salivatory fibers in the auriculotemporal nerve toward overlying sweat glands. However, the exact mechanism behind this growth is unknown. This review aims to expand and elucidate the theory of aberrant regeneration in FS.
METHODS: A review of the recent literature on nerve regeneration was conducted in order develop further insights into the etiology of both adult onset and pediatric FS.
RESULTS: Neurturin, a neurotrophic factor released by both salivary and sweat glands, was identified as a possible key player in the etiology of FS.
CONCLUSIONS: Further research into the role of neurturin could help to elucidate the pathogenic mechanisms underlying the condition and might reveal neurturin to be a potential target for pharmacological intervention.
METHODS: NA (Basic Science Review).

Botulinum toxin type-A (BTX-A) injection for treating chronic migraine (CM) has developed into a new technique covering distinct injection points in the head and neck regions. The postulated analgesic mechanism implies that the injection should be administered to sensory nerves rather than to muscles. This study aimed to determine the topographical site of the auriculotemporal nerve (ATN) and to propose the effective injection points for treating CM. ATNs were investigated on 36 sides of 25 Korean cadavers. The anatomical structures of the ATN were investigated focusing on the temporal region. A right-angle ruler was positioned based on two clearly identifiable orthogonal reference lines based on the canthus and tragus as landmarks, and photographs were taken. The ATN appeared superficially in the anterosuperior region of the tragus. The nerve is located deeper than the superficial temporal artery. And it runs between the artery and the superficial temporal vein. In the superficial layer, it is divided into anterior and posterior divisions. The anterior division runs in a superior direction, while the posterior division runs in front of the ear and the several branches are distributed to the skin. We suggest that the optimal BTX-A injection points for CM are in the temporal region. The first point is about 2 cm anterior and 3 cm superior to two orthogonal reference lines defined based on the tragus and canthus, and the second point is about 4 cm superior to the first point. The third and fourth points are recommended about 2 cm superior to the first point, but respectively 1 cm anterior and posterior to it.

Frey\'s syndrome in children is rare and often erroneously attributed to food allergy. A description of a case of Frey\'s syndrome in a child and a review of the literature is provided. Awareness of this condition is important for the pediatric dentist to avoid unnecessary medical procedures and provide reassurance to the dental team in the setting of this benign condition.

Cluster headache is a primary headache disorder, which has affected up to 0.1% population. Superficial temporal artery ligation combined with auriculotemporal nerve transection (SLAT) is one of the surgical alternatives to treat the drug-resistant temporal cluster headache (TCH). The current work aimed to assess the effect of SLAT on TCH patients based on the very long-term clinical follow-up.
The current retrospective study had enrolled 20 adolescent TCH patients undergoing SLAT between December 2016 and January 2018. The headache diaries as well as the pain severity questionnaire of the visual analog scale (VAS) had been collected to measure the pain severity before and after surgery.
The pain-free rates 3 days, as well as 1, 6, and 12 months, after SLAT surgery were 2.00%, 10.00%, 25.00%, and 70.00%, respectively. The frequency of TCH attack daily was found to be markedly reduced on the whole; besides, the pain degree was also remarkably decreased.
Results in this study indicate that the sustained headache can be relieved after SLAT in adolescent patients with intractable TCH.