Otomandibular Ligaments: Anatomical Exploration and Clinical Application in Humans

Abstract

Ligamentous structures connecting the middle ear and temporomandibular ligament (TMJ) are called as Otomandibular ligaments (OML). Most of the anatomists believed that OML has two parts: malleomandibular ligament (MML) and Discomallear ligament (DML). Both of these ligaments pass through the bony fissure which runs from TMJ to the tympanic cavity, called as Petrotympanic fissure (PTF). Anatomical connection between TMJ and middle ear persists mainly due to continuation of common Meckels structure through petro tympanic fissure (PTF). Embryological origin of the MML and DML is debatable but basically, they originates from the first arch. Though they do not play important role in primary movement of TMJ, joint dislocation, anterior disc displacement and hypermobility could happen due to stretching of the DML. MML provides the mechanical support to the head of malleus and forms a movable unit, which acts as suspensory structure for the ossicular chain. Therefore, structural alteration in the MML may plays an important role in affecting middle ear function. The disruption of MML during chronic infection or surgical release of malleus head fixation may affects middle ear sound transmission and results in conductive hearing loss. Shortening of DML by laser coagulation which permits its tightening has been suggested for the treatment of the anterior displacement of the disc. This shortening technique reduces the articular movement range, due to which it was also indicated in the treatment of recurrent temporomandibular dislocations.