Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

Abstract

Background: Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose: To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods: DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results: In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion: The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study.