Temporomandibular Joint and Correlated Fissures: Anatomical and Clinical Consideration

Abstract

An anatomical study of the fissures related to the temporomandibular joint (TMJ) was performed in 40 dry human skulls. The length of the squamotympanic fissure (X), as well as those of the petrotympanic fissure (Y) and the (descending part of) the petrosquamous fissure (Z), into which the first of them (as a rule) branches, was measured. The distances between the point of this bifurcation and the deepest point of the glenoid fossa (A), the articular tubercle (B), and the styloid process (C) of the TMJ were also measured. The distances measured presented a significant variability among different specimens. In particular, the lengths (X, Y, and Z) of some fissures measured twice as great compared to other ones. All distance measurements were expressed in mm. Dysfunction of the TMJ may lead to a variety of ear symptoms, i.e., otalgia, tinnitus, hearing loss, possibly vertigo and, less often, to tongue symptoms (collectively characterized as temporomandibular syndrome). These symptoms often relate to the important anatomic structures (anterior malleolar ligament, anterior tympanic artery and chorda tympani nerve) coursing (mainly) through the petrotympanic fissure, whose length and position may exert considerable impact. The measured distances (hardly assessable through a plain radiogram) may also be considered as parameters that need to be taken into account in view of an eventual replacement of a poorly functioning TMJ by a suitable prosthesis.

Caracterización de los Componentes Óseos de la Articulación Temporomandibular: Una Revisión de la Literatura

“…2 y 3) (Okeson;Sicher & Dubrul;Bumann & Lotzmann;Alves & Candido;Platzer, 2013). Confirmando lo anterior, en un estudio realizado por Anagnostopoulou et al (2008) en 40 cráneos secos humanos, encontraron en el 92,5% tres fisuras claramente distinguibles en la fosa mandibular (fisuras timpanoescamosa, petrotimpanica y petroescamosa). Sólo en el 7,5% restante, la fisura timpanoescamosa no se dividía debidamente en las fisuras petrotimpanica y petroescamosa.…”

High resolution CT study of the chorda tympani nerve and normal anatomical variation

“…To the best of the authors' knowledge, study of the CTN has been limited to cadaveric studies. Our classification of the CTN has clinical relevance as the posterior canaliculus is prone to iatrogenic injury during neurotologic procedures, and the anterior canaliculus is at risk for involvement in traumatic petrotympanic fractures and neighboring TMJ pathology [1,6,9,10].…”

“…Consequences of nerve injury may range from minimal symptoms to debilitating loss or altered taste sensation and dryness of the mouth. Less well recognized etiologies of CTN dysfunction include trauma to the temporal bone and various temporomandibular joint (TMJ) pathologies [9,10]. Previous studies of the CTN have been limited to high-resolution computed tomography (HRCT) evaluation of temporal bones from cadavers [11,12].…”

The canine jaw‐ear connection: The malleomandibular and tympanomandibular ligaments

“…Anomalies of the temporomandibular joint, jaw malocclusion and dentition have all been linked to various hearing problems. Temporomandibular joint disorders and jaw malocclusion may result in symptoms such as otalgia, tinnitus, vertigo, a stuffy sensation or auricular fullness, and hearing loss (Pinto, ; Cândido dos Reis et al, ; Lawrence et al, ; Anagnostopoulou et al, ). Loughner et al () reported two cases of disruption of articulation of the auditory ossicles during surgical procedures on the TMJ where partial or total deafness resulted on the ipsilateral side.…”