Mandibular-malleolar ligament
WHAT IS TMJ?
TMJ is a disorder of the jaw joint and related structures where the ball (condyle), socket (fossa), and cushioning disk (meniscus) of the joint are damaged or misaligned (Note 1) . Over time, the meniscus becomes increasingly compressed and torn, allowing the bony structures of the ball and socket to deteriorate at an accelerating rate due to the grinding wear on the joint and the loss of cushioning effect of the meniscus. This grinding (crepitus) and concurrent pressure on the capsular ligament surrounding the joint can cause head pain, and may create difficulty in opening or closing of the mouth. The body attempts to realign the joint using the musculature in the face, jaw and neck. As these muscles become fatigued, additional muscles in the shoulders and back attempt to help this condition, then become stressed themselves. This can cause symptoms of generalized muscle pain and weakness that are diagnosed as Myofascial Pain Dysfunction Syndrome (Fibromyalgia) (Note 2) and/or Chronic Fatigue Syndrome.
The misalignment of the joint can also affect the nearby ear structures, due to pressure on the petrotympanic fissure and tympanic bone. The tympanic bone separates the jaw joint from the ear canal. The mandibular malleolar ligament (disco-malleolar ligament) connects the malleous as this ligament traverses through the fissure to attach to the meniscus and the capsular ligament of the TMJ. The capsular ligament is the sac surrounding the joint. The anterior tympanic artery, which is responsible for supplying oxygenated blood to the tissue around the tympanic membrane (ear drum) travels through this fissure. The chorda tympani nerve traverses through this fissure. This nerve gives pain sensation to the tongue (Note 3) . Pressure on these structures can cause dysfunction and symptoms such as ear pain, tinnitus (ringing in the ears), vertigo (dizziness), subjective hearing loss, hyperacusis (increased sensitivity to sound), Chronic Fatigue Syndrome, tongue pain, muscle pain, and other symptoms.
Mandibular-malleolar ligament
Research Confirms TMJ-Tinnitus Connection