The annular ligament of the stapes is a ring of elastic fibrocartilage connecting the footplate of the stapes to the oval window margin, providing both a flexible seal and the suspension for the stapes footplate.
Provides the spring-loaded suspension that allows the stapes footplate to piston into the oval window during sound transmission while maintaining the perilymph seal. Its elasticity is critical for efficient sound energy transfer to the cochlea.
Fixation of the annular ligament (otosclerosis) is the most common cause of adult conductive hearing loss. Stapedectomy or stapedotomy involves creating a hole through the stapes footplate and placing a prosthesis, with the annular ligament remnants forming the seal around the prosthesis.
Abnormal bone deposition fixing the annular ligament and stapes footplate, producing progressive conductive hearing loss treated by stapedectomy or stapedotomy with prosthesis placement.
Perilymphatic fistula from annular ligament disruption in temporal bone fracture, producing fluctuating sensorineural hearing loss and episodic vertigo.
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