The discomalleolar ligament (Pinto’s ligament) is not described in the anatomy textbooks
but was demonstrated by Pinto and others. This is a ligamentous structure
connecting the malleus in the tympanic cavity and the articular disc and capsule of
the temporomandibular joint. This anatomical relationship between the middle ear
and the temporomandibular joint is supposed to be one of the explanations for the
aural symptoms associated with temporomandibular joint dysfunction.
The objectives of our study were to determine: (1) the frequency of occurrence
and morphology of the discomalleolar ligament, (2) its attachments, (3) the morphology
of Pinto’s ligament in endoscopic visualisation, and (4) whether tension
applied to the discomalleolar ligament could elicit movement of the malleus. Fourteen
adult human temporomandibular joint and tympanic cavity specimens were
examined with the use of an endoscope and then by gross dissection with the
superior approach and with the use of the operating microscope.
Endoscopic visualisation showed in four cases a band of tissue in the upper
temporomandibular joint compartment, known as Pinto’s ligament. The dissections
exposed a discomalleolar ligament in 11 specimens. We were able to identify
two main types of this ligament on the basis of its shape. The discomalleolar
ligament was either triangular in shape, as in the first group of seven specimens,
or longitudinal in shape, as in the second group of four specimens. We observed
that tension applied to the discomalleolar ligament resulted in movement
of the malleus in three specimens
