European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 8, pp 2141–2148 | Cite as

Pars tensa and tympanicomalleal joint: proposal for a new anatomic classification

  • Nelson GilbertoEmail author
  • Ricardo Santos
  • Pedro Sousa
  • Assunção O’Neill
  • Pedro Escada
  • Diogo Pais



The tympanic membrane (TM) belongs to the ear. Despite its place in the ear anatomy, can we give it also a different anatomic classification? The main objective is to clarify the nature of TM, tympanic bone and malleus to propose a new anatomic classification.


This cadaveric study was performed in two human heads and six fresh temporal bones. A study of the temporomandibular joint, external acoustic meatus (EAM), TM and middle ear structures was conducted. A medical literature review englobing anatomy, embryology, histology and phylogeny of the ear was performed and the results were compared with the results of the dissection.


The external ear is constituted by the auricle and the EAM. This last segment is made by a cartilaginous and an osseous portion. The osseous portion of the EAM is constituted mainly by tympanic bone. The external ear is separated from the middle ear by the TM. Inside the middle ear, there are three ossicles: malleus, incus and stapes, which allow the conduction of sound to the cochlea. Based on the anatomic dissection and medical literature review of the tympanic bone, malleus and TM, we propose that these structures are interconnected like a joint, and named it “Tympanicomalleal joint”.


It seems that the TM can be part of a joint that evolved to improve sound transmission and middle ear protection. Thinking TM has part of a joint may help in the development of more efficient reconstructive surgical techniques.


Anatomy External ear Middle ear Ear ossicles Tympanic membrane Tympanoplasty 



The authors would like to thank to Carlos Ruah, MD PhD, for his help in writing this manuscript and to Mr. Vyacheslav Sushchyk for his help in the anatomic dissections.


The authors have no funding or financial relationships to disclose.

Compliance with ethical standards

Conflict of interest

None of the authors have conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any animal studies performed by any of the authors.

Informed consent

Written consent for donation was obtained from each individual prior to death.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Centro Hospitalar de Lisboa Ocidental EPE, Nova Medical School, Egas Moniz HospitalNew University of LisbonLisbonPortugal
  2. 2.Department of Anatomy, Nova Medical SchoolNew University of LisbonLisbonPortugal
  3. 3.Emergency DepartmentHospital das Forças ArmadasLisbonPortugal

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