Discomallear Ligament: A Review with a clinical Approach

The discomallear ligament is described as a fibrous connection that anatomically and functionally relates the malleus bone in the middle ear to the posteromedial portion of the joint capsule through the petrotympanic fissure. It is a structure that presents important clinical aspects, since it may be related to otologic symptoms in temporomandibular joint dysfunctions. The objective of the present study was to perform a systematic review of the presence of the discomallear ligament, its possible influences on otologic symptoms and correlation with temporomandibular dysfunction. The analyzed sources of the literature review were searched in PubMed, Scielo, Web of Science, Lilacs, Google Scholar and Ebsco databases through a combination of keywords. An analysis of anatomical specimens was performed through the inspection of 277 adult skulls and 9 infant skulls, in order to verify the presence of foramina in the petrotympanic fissure on both sides. A computed tomography image was included in this study and showed a hypodense circular structure suggestive of foramen and possible passage of this ligament towards the disc of the temporomandibular joint. The evaluation of the anatomical parts showed that the adult skulls analyzed, about 90% had a foramen on both sides, 1.44% on the right side only, 4.33% on the left side only and 3.61% did not present foramen in any of the sides. About the children's skulls, 33.3% had a foramen on both sides, 33.3% on the right side and 33.3% had no foramen on either side. In results, the methods evaluated and the studies analyzed show the anatomical relationship between the tympanic cavity and temporomandibular joint, as well as the existence of the discomallear ligament and its possible influence on the otologic symptoms caused by temporomandibular disorders.