Surgical and Radiologic Anatomy

, Volume 26, Issue 1, pp 39–45 | Cite as

The discomallear ligament and the anterior ligament of malleus: An anatomic study in human adults and fetuses

  • H. J. Kim
  • H. S. Jung
  • H. H. Kwak
  • K. S. Shim
  • K. S. Hu
  • H. D. Park
  • H. W. Park
  • I. H. Chung
Original Article
First Online:
Received:
Accepted:

Abstract

According to some reports, movement of the malleus, resulting from anterior hypertension on the discomallear ligament (DML), could produce aural symptoms related with damage to middle ear structures. The aim of this study was to examine the topographic relationship of the DML and the anterior ligament of malleus (ALM). Four fetuses and 16 adult hemi-sectioned heads were used to determine the anatomic-clinical relevance of DML and ALM in temporomandibular disorder. In fetal specimens, the DML was distinctly interposed between the malleus and the disc of the temporomandibular joint (TMJ), and the ALM had a structure apparently composed of the superior and inferior lamellae, running anteriorly in continuation with the sphenomandibular ligament (SML) through the future petrotympanic fissure (PTF). In all adult specimens, the DML was inserted into the malleus, and it expanded broadly toward the disc and capsular region of the TMJ in a triangular shape and inserted into the disc and capsule of the TMJ. The two-lamellae structure of the ALM was not distinguishable in adult specimens. The overstretched ALM resulted in movement of the malleus in five cases, but similar tension applied to the DML did not cause any movement of the malleus. This result provides an indication of the clinical significance of the ALM, a ligamentous structure continuous with the SML. It is apparent that the ALM has the potential to cause aural symptoms as a result of damage to the middle ear structure.

Keywords

Discomallear ligament Anterior ligament of malleus Sphenomandibular ligament Petrotympanic fissure 
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Notes

Acknowledgements

This study was supported by Yonsei University College of dentistry fund of 2001. We would like to express our thanks to Ms. Seung Hye Kim, a student of dental college of Yonsei University, for reviewing this article.

References

  1. 1.
    Baume LJ, Holz J (1970) Ontogenesis of the human temporomandibular joint. 2. Development of the temporal components. J Dent Res 49: 864–875PubMedGoogle Scholar
  2. 2.
    Beck F, Moffat DB, Lloyd JB (1973) Human embryology and genetics. Blackwell Scientific Publications, Oxford, pp 200–201Google Scholar
  3. 3.
    Burch JG (1966) The cranial attachment sphenomandibular (tympanomandibular) ligament. Anat Rec 156: 433–438PubMedGoogle Scholar
  4. 4.
    Cameron J (1915) The cranial attachment of the internal lateral ligament of the lower jaw: with an investigation into fibrogenesis of this structure. J Anat Physiol 49: 210–215Google Scholar
  5. 5.
    Cesarani A, Tombolini A, Fagnani E, Domenech Mateu JM (1991) The anterior ligament of the human malleus. Acta Anat 142: 313–316Google Scholar
  6. 6.
    Coleman RD (1970) Temporomandibular joint: relation of the retrodiscal zone to Meckel’s cartilage and lateral pterygoid muscle. J Dent Res 49: 626–630PubMedGoogle Scholar
  7. 7.
    Enlow DH (1982) Handbook of facial growth, 2nd edn. Saunders, London, pp 362Google Scholar
  8. 8.
    Furstman L (1963) The early development of the human temporomandibular joint. Am J Orthod 49: 672–682Google Scholar
  9. 9.
    Hanson JR, Anson BJ, Strickland EM (1962) Branchial sources of the auditory ossicles in man. Part II: observation of embryonic stages from 7 mm to 28 mm. Arch Otolaryngol 76: 200–215Google Scholar
  10. 10.
    Harpman JA, Woollard HH (1938) The tendon of the lateral pterygoid muscle. J Anat 73: 112–115Google Scholar
  11. 11.
    Ioannides CA, Hoogland GA (1983) The disco-mallear ligament; a possible cause of subjective hearing loss in patients with temporomandibular joint dysfunction. J Maxillofac Surg 11: 227–231PubMedGoogle Scholar
  12. 12.
    Kjellberg K (1904) Beitrage zur Entwicklungsgeschichte des Kiefergelenks. Gegenbaurs Morphol Jahrb 32: 159–184Google Scholar
  13. 13.
    Komori E, Sugisaki M, Tanabe H, Katoh S (1986) Discomallear ligament in the adult human. J Craniomandib Pract 4: 300–305Google Scholar
  14. 14.
    Loughner BA, Larkin LH, Mahan PE (1989) Discomallear and anterior mallear ligaments: possible causes of middle ear damage during temporomandibular joint surgery. Oral Surg Oral Med Oral Pathol 68: 14–22PubMedGoogle Scholar
  15. 15.
    Loughner BA, Gremillion HA, Mahan PE, Watson RE (1997) The medial capsule of the human temporomandibular joint. J Oral Maxillofac Surg 55: 363–369PubMedGoogle Scholar
  16. 16.
    Ogutcen-Toller M (1995) The morphogenesis of the human discomallear and sphenomandibular ligaments. J Craniomaxillofac Surg 23: 42–46PubMedGoogle Scholar
  17. 17.
    Ogutcen-Toller M, Juniper RP (1993) The embryologic development of the human lateral pterygoid muscle and its relationships with the temporomandibular joint disc and Meckel’s cartilage. J Oral Maxillofac Surg 51: 772–778PubMedGoogle Scholar
  18. 18.
    O’Rahilly R, Gardner E (1976) The embryology of bone and joints. Bone and joint. IAP Monograph no. 17. Williams & Wilkins, Baltimore, p 1Google Scholar
  19. 19.
    Perry HT, Xu Y, Forbes DP (1985) The embryology of the temporomandibular joint. J Craniomandib Pract 3: 125–132Google Scholar
  20. 20.
    Pinto OF (1962) A new structure related to the temporomandibular joint and middle ear. J Prosthet Dent 12: 95–103Google Scholar
  21. 21.
    Rees LA (1954) The structure and function of the mandibular joint. Br Dent J 96: 125–133Google Scholar
  22. 22.
    Rodriguez Vazquez JF, Merida Velasco JR, Jimenez Collado J (1992) Development of the human sphenomandibular ligament. Anat Rec 233: 453–460PubMedGoogle Scholar
  23. 23.
    Rodriguez Vazquez JF, Merida Velasco JR, Jimenez Collado J (1993) Relationships between the temporomandibular joint and the middle ear in human fetuses. J Dent Res 72: 62-66PubMedGoogle Scholar
  24. 24.
    Rodriguez Vazquez JF, Merida Velasco JR, Merida Velasco JA, Jimenez Collado J (1998) Anatomical considerations on the discomallear ligament. J Anat 192: 617–621CrossRefPubMedGoogle Scholar
  25. 25.
    Smeele LE (1988) Ontogeny of relationship of human middle ear and temporomandibular (squamomandibular) joint I. Morphology and ontogeny in man. Acta Anat 131: 338–341Google Scholar
  26. 26.
    Strickland EM, Hanson JR, Anson BJ (1962) Branchial sources of auditory ossicles in man. Arch Otolaryngol 76: 100–123Google Scholar
  27. 27.
    Toledo Filho JL, Luiz Zorzetto N, Caldas Navarro JA (1985) Structures and relationships of the anterior malleus ligament. Anat Anz 158: 13–22PubMedGoogle Scholar
  28. 28.
    Wong GB, Weinberg S, Symington JM (1985) Morphology of the developing articular disc of the human temporomandibular joint. J Oral Maxillofac Surg 43: 565–569PubMedGoogle Scholar
  29. 29.
    Yuodelis RA (1966) The morphogenesis of the human temporomandibular joint and its associated structures. J Dent Res 45: 182–191PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • H. J. Kim
    • 1
  • H. S. Jung
    • 1
  • H. H. Kwak
    • 1
  • K. S. Shim
    • 1
  • K. S. Hu
    • 1
  • H. D. Park
    • 1
  • H. W. Park
    • 2
  • I. H. Chung
    • 2
  1. 1.Division in Anatomy and Histology, Department of Oral Biology, College of Dentistry, Oral Science Research Center, Brain Korea 21 Project for Medical ScienceYonsei UniversitySeoul Korea
  2. 2.Department of Anatomy, College of Medicine, Brain Korea 21 Project for Medical ScienceYonsei UniversitySeoulKorea

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