Auricular

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Auricular Scalp Acupuncture Review

• ACR class 13

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Auricular
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Anatomy Somatatopic Representation
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• Modern Auriculotherapy founded by Paul Nogier in
  1950s France
• Also developed in 1960s China
• Some differences in point location but overall
  very similar
• Fetal / Upside-down man representation

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• Lobe Face sensory
• Antitragus Cranial brain
• Internal organs in concha
• Thorax Inferior (Cavum) concha
• Abdomen Superior (Cymba) concha
• Digestive around helix crus

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• Spine on antihelix
• Upper limb on scaphoid fossa
• Lower limb on upper antihelix crus
• Triangular fossa Chinese Reproductive
  Shenmen French Lower limb

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• Lobe Cranial area/face/sensory on lobe
• Internal organs in concha
• Spine on antihelix
• Upper limb on scaphoid fossa
• Lower limb on upper antihelix crus
• Triangular fossa Chinese Reproductive
  Shenmen French Lower limb

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NADA Protocol

• AKA 5-Needle Protocol, 5NP
• Most common auricular protocol used today
• Use for addictions, trauma, pain, etc

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• Shen Men Slightly superior and anterior to the
  tip of the triangular fossa.
• Sympathetic-Autonomic point Junction of the
  internal helix and the inferior antihelix crus.
  It is covered by the fold of the helix.
• Liver Junction of the concha ridge/helix crus
  with the posterior concha wall (just anterior to
  antihelix). Some maps place it slightly superior
  to the concha ridge.

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• Kidney In superior concha, near concha wall,
  directly below Shen Men.
• Lung 2 In lower part of inferior concha, just
  below deepest part of concha (Heart point).

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Diagnosis

• Ear probe - look for painful points
• Electronic point finder - low skin resistance
• Visual inspection - Discoloration

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Treatment

• Filiform needles
• Press tacks or intradermals
• Seeds
• Bleeding
• Ear massage
• Electric stim
• Cold laser

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Needling

• Disinfect skin with alcohol
• Use 15mm, 7mm or press tack
• Filiform needle retain 20-40 minutes
• Check for bleeding on removal of needle

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Precautions

• Do not needle if external ear is infected or
  inflamed
• Contraindicated for pregnancy with history of
  miscarriage caution otherwise
• Caution weak constitution
• Do not leave tacks or seeds more than 1 week

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Scalp Acupuncture
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Scalp Acupuncture

• Several different systems Jiao, Zhu, Yamamoto
  (YNSA), etc
• Jiao system most common

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Motor Area

• Location Locate the upper point 0.5 cm posterior
  to the mid-point of the anterior-posterior
  midline.
• Then locate the lower point at the intersection
  of the eyebrow-occiput line with the anterior
  temporal hairline.
• The line connecting the upper and lower points is
  the motor area.
• This line is divided into five equal portions.

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Motor Area

• Lower limb and trunk area Location Upper 1/5 of
  the motor area. Indications Contralateral
  paralysis of the lower limbs.
• Upper limb area Location Middle 2/5 of the motor
  area. Indications Paralysis of the upper limbs.
• Facial area Location Lower 2/5 of the motor
  area. Indications Facial paralysis, motor
  aphasia, salivation, impaired speech, and
  dysphonia.

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Sensory Area

• Location The line parallel to and 1.5 cm
  posterior to the motor area. Divide this line
  into five equal portions.
• Lower limb, head, and trunk area Location Upper
  1/5 of sensory area. Indications Contralateral
  lumbar pain, leg pain, numbness, paresthesia,
  occipital headache, neck pain, tinnitus.
• Upper limb area Location Middle 2/5 of the
  sensory area. Indications Upper limb pain,
  numbness, paresthesia.
• Facial area Location Lower 2/5 of the sensory
  area. Indications Facial numbness, migraine,
  trigeminal neural- gia, toothache,
  temporomandibular arthritis.

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• Chorea Tremor Control Area
• Location Parallel and 1.5 cm anterior to the
  motor area. Indications Chorea, Parkinsons
  disease.
• Blood vessel dilation and constriction area
• Location Parallel and 1.5 cm anterior to the
  chorea and tremor control area. Indications
  Superficial edema, hypertension.

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• Vertigo and hearing area
• Location A horizontal line 1.5 cm above the ear
  apex 2 cm anterior and 2 cm posterior (total 4.0
  cm length). Indications Tinnitus, vertigo,
  diminished hearing, Menieres syndrome.
• Speech 3
• Location A horizontal line starting at the
  midpoint of the Vertigo and Hearing Area and
  running posteriorly 4.0 cm in length.
  Indications Sensory aphasia.

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• Speech 2
• Location A vertical line 2.0 cm posterior and
  inferior to the parietal tubercle 3.0 cm in
  length. Indications Nominal aphasia.
• Voluntary Movement / Usage area
• Location At the parietal tubercle origin, three
  lines run inferiorly, anteriorly, and posteriorly
  3.0 cm each with a 40 angle between each of the
  lines. Indications Apraxia.

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Foot Motor and Sensory Area

• Location Two lines 1.0 cm lateral to the
  midpoint of the anterior-posterior midline 3.0 cm
  in length posterior and parallel to the midline.
  
• Indications Contralateral lower limb pain,
  numbness, paralysis, acute lumbar sprain,
  nocturia, and uterine prolapse.

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• Vision area
• Location Two lines 1.0 cm lateral to the
  midpoint of the external occipital protuberance,
  parallel to the anterior-posterior midline, 4.0
  cm in length extending superiorly. Indications
  Visual disturbances, cortical blindness.
• Balance area
• Location Two lines 3.5 cm lateral to the
  midpoint of the external occipital protuberance,
  parallel to the anterior-posterior midline, 4.0
  cm in length extending inferiorly. Indications
  Loss of balance due to cerebellar disorders,
  dizziness.

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• Stomach area
• Location Beginning at the hairline directly
  superior to the pupil of the eye, parallel with
  the anterior-posterior midline, 2.0 cm in length
  bilaterally extending posteriorly. Indications
  Stomach / epigastric pain.
• Thoracic cavity
• Location Beginning 2.0 cm below the hairline,
  midway between and parallel to the stomach area
  and the anterior- posterior midline, 4.0 cm in
  length bilaterally extending superiorly.
  Indications Chest pain, palpitations, coronary
  heart disease, asthma, and hiccups.

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• Reproduction area
• Location Beginning at the hairline, a line 2.0
  cm in length from the frontal angle extending
  posteriorly and parallel to the
  anterior-posterior midline. Indications
  Functional uterine bleeding, pelvic inflammation,
  leukorrhea, and uterine prolapse.

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• Liver and Gallbladder Area
• Location Beginning at the hairline, a line 2.0
  cm in length from the stomach area extending
  inferiorly. Indications Upper right quadrant
  abdominal pain, chronic hepatitis, abdominal pain
  due to liver and gallbladder disease.
• Intestine Area
• Location Beginning at the hairline, a line 2.0
  cm in length from the reproduction area extending
  inferiorly. Indications Lower abdominal pain.

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Needle Technique

• Clean insertion site with alcohol
• Use 1-2 cun filiform needles, 28-32 gauge
• Insert 30 angle, thread into aponeurosis
• Twirling manipulation, up to 200x/minute
• Manipulate 2-3 minutes, rest 5-10 minutes and
  repeat 2-3 times or use high frequency e-stim
  (200-300 hz)

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Precautions

• Seated or lying position watch for fainting
• Not advisable for weak patients, high fever,
  local inflammation, heart failure
• Contraindicated if open head wounds or
  intracranial bleeding wait until bleeding has
  stopped and patient is stable