Anatomical and functional aspects of ligaments between the malleus and the temporomandibular joint.

The aim of this paper is to investigate the anatomical topography and the relationship between the ligaments, malleus and temporomandibular joint (TMJ) and to determine the role of these ligaments on the movement of the malleus. The malleus, incus, petrotympanic fissure (PTF), chorda tympani, anterior malleolar ligament (AML), discomallear ligament (DML), malleomandibular ligament, sphenomandibular ligament and articular disc were explored in 15 skulls. Traction and tension tests were carried out to clarify their role in malleolar movement. In 12 of the cases, two separate ligaments were connected to the anterior of the malleus, whereas a single ligament from the anterior of the malleus to the PTF was observed in 3 cases. In 12 cases, the DML united the retrodiscal tissues. In the other 3 cases, the medial and the lateral parts of the ligament were connected to the retrodiscal tissue after passing through the PTF. The thickness of the ligaments differed among specimens. When tension was applied to the DML no malleolar movement occurred, but when the AML was overstretched, significant movement was observed in 5 cadavers; little movement in 6 cadavers, and no movement in 4 cadavers. This study suggests that extreme stretching of the condyle in conjunction with the ligaments between the ossicles of the inner ear and the TMJ could be the reason for unexplained otological problems.