Análisis de los términos utilizados en la literatura científica para referirse a los ligamentos extracapsulares de la articulación témporomandibular: Parte I: Ligamentum sphenomandibulare / A study of terms used in scientific literature to refer to the extracapsular ligaments of the temporomandibular joint: Part I: Ligamentum sphenomandibulare

La Terminología Anatómica es la base de correcta comunicación anatómica y establece la unificación internacionalmente aceptada para diversas estructuras anatómicas. Sin embargo, su uso en la literatura pedagógica y científica no se ha aplicado por completo. El objetivo de esta investigación fue analizar la literatura en relación al uso correcto de los términos referentes al Ligamento esfenomandibular de la Articulación témporomandibular (ATM). Se realizó una revisión en libros de anatomía y artículos científicos relacionados y se comparó el uso de términos referentes al ligamento esfenomandibular con la Terminología Anatómica Internacional (TAI). Se encontraron diferencias en cuanto a los términos usados (sinonimia) para referirse tanto al ligamento esfenomandibular, así como a las estructuras que sirven de origen e inserción a este con los términos establecidos por la TAI en latín, inglés y algunos términos traducidos al español. La sinonimia y uso de epónimos encontrados dificultan la comunicación entre los científicos del área, así como el aprendizaje de los alumnos de pregrado y postgrado, cuya principal fuente de estudio continúan siendo los libros de anatomía.

Terminología Anatómica is currently the international standard for anatomical terminology, and establishes an internationally accepted and unified nomenclature for several anatomical structures. However, International Anatomical Terminology (IAT) is not always used correctly in scientific literature. The purpose of this review is to examine scientific literature in order to determine whether the terms that refer to the sphenomandibular ligament of the temporomandibular joint (TMJ) are being used correctly. Scientific books and articles were reviewed, and the terms used were compared with those established by the IAT. Our study found differences between the terms actually used (Synonyms) to refer to the sphenomandibular ligament and to the anatomical structures where the ligament originates and where it is inserted and those established by the IAT in Latin, English and some terms translated into Spanish. The use of eponyms and synonyms found, creates difficulties in communication between scientists and in the learning process of undergraduate students, who frequently use textbooks.

Frequency of occurence of the discomalleolar ligament in the adult man / Frecuencia aparición del ligamento discomaleolar en el hombre adulto

The discomaleollar ligament is not described in the anatomy textbooks but was demonstrated by Pinto (1962) and others. It is a ligamentous structure connecting the malleus in the tympanic cavity and the articular disc and the capsule of the temporomandibular joint. This anatomical relationship between the middle ear and temporomandibular joint is supposed to be one of the explanations for the otological symptons associated with temporomandibular joint dysfunction. The aim of our study was to determine the frequency of occurence of the discomaleollar ligament. Twenty hemi-heads of adults human were carefully dissected from a superior approach through the middle cranial fossa. The bone of the middle cranial fossa over the temporomandibular joint region and the roof of the tympanic cavity were carefully removed to expose the articular disc, ossicles of the middle ear, lateral pterygoid muscle and other structures in the region. The discomalleolar ligament was found in all studied cases what allow us to suggest that it is an intrinsic ligament of the temporomandibular joint.

El ligamento discomaleolar no se describe en los textos de anatomía, pero ha sido demostrado por Pinto (1962) y otros. Es una estructura ligamentosa que conecta el maléolo en la cavidad timpánica con el disco articular y la cápsula de la articulación temporomandibular. Esta relación anatómica entre el oído medio y la articulación temporomandibular se supone que es una de las explicaciones de los síntomas otológicos asociados a la disfunción temporomandibular. El objetivo de nuestro estudio fue determinar la frecuencia de aparición del ligamento discomaleolar. Veinte hemi-cabezas de individuos adultos fueron cuidadosamente disecadas desde un acceso superior a través de la fosa craneal media. Se retiró el hueso de la fosa craneal media sobre la región de la articulación temporomandibular y el techo de la cavidad timpánica, para exponer el disco articular, osículos del oído medio, músculo pterigoideo lateral y otras estructuras en la región. El ligamento discomaleolar se encontró en todos los casos estudiados, lo que nos permite sugerir que es un ligamento intrínseco de la articulación temporomandibular.

Topographic Anatomy of the Discomalleolar and Anterior Malleolar Ligaments in Human Adults and Fetuses / 체질인류학회지

During temporomandibular joint (TMJ) formation, discomalleolar ligament (DML) and anterior malleolar ligament (AML) are formed within the dorsal end of the 1st branchial arch. But, DML is known as a remnant or the degenerated tissue through the TMJ development. There is few reports said that damage of AML and DML cause the damage of middle ear during surgical procedures. Especially, in case of anterior disk displacement of TMJ, aural symptom can be made via DML due to hyperextension anteriorly. A few studies have been reported about DML and AML in embryological and histological points of view, morphology and clinical aspects of DML and AML are still unclear. Four fetuses and sixteen adult hemi -sectioned heads were dissected to clarify the topographical relationship of AML and DML and to find out the anatomico -clinical relevance related with temporomandibular disorder. In fetal specimens, DML was firmly attached from the disk of the TMJ to the malleus. Also, AML in which distinguished into the superior and inferior lamellae was running anteriorly and continuous with the sphenomandibular ligament (SML) through the future petrotympanic fissure (PTF). DML attached to the malleus was observed in all adult specimens and was expanded broadly to the disk and capsule of the TMJ as shown the V -shaped ligament structures. The average distance between the anterior aspects of the malleolar head to the anterior wall of the tympanic cavity was 1.13 mm(0.75 ~1.59), and the length of the DML from the anterior aspect of the malleolar head to the attached site to the TMJ capsule at the PTF was 5.37 mm (4.53 ~6.07). The average width of the DML at the PTF was 6.06 mm (4.72 ~7.46). Most of the posterior attachments of the DML were the cases in which DML was directly attached to the malleus (68.7%). In all specimens, DML was attached to the disk and capsule of TMJ and attached to the anteromedial border of the PTF concurrently. In this study, two morphological patterns of AML were observed according to the presence of the bony ridge on the Huguiers canal in the PTF. The bony ridge of the Huguiers canal showed DML and AML separately in 56.3%, and the fused pattern of DML and AML was observed in 43.7%. AML was not distinguished with two lamellae in most specimens, superior ligament fibers were attached to the anteromedial border of the PTF and most of the inferior lamella was entering the gap in PTF and continuous with the SML. Average length from the anterior aspect of the malleolar head to the exit point of the AML on the PTF was 8.40 mm(6.62 ~11.42), and the shortest distance between the AML and chorda tympani was 2.01 mm(1.25 ~3.02). Taken all together, DML and AML were not the rudimentary, but the distinguishable structures in adults. Through the various morphological findings, DML and AML were separated ligamentous structures in which might be given rise from the divergent origin. And the anterior hyperextension of the disk of TMJ did not lead the movement of the malleus in the tympanic cavity, whereas, the movement of the malleus followed by the traction of the AML and SML was observed in a few cases. So, this results can be explained the possibility of the clinical symptom on the middle ear in case of the over -traction of the AML and SML.