The posterior ligament of the incus connects the short process of the incus to the posterior wall of the epitympanum (incudal fossa), providing the posterior anchor for the ossicular chain.
Suspends the short process of the incus, acting as a pivot point around which the ossicular chain rotates during sound transmission. Critical for maintaining the incus in correct position relative to the malleus and stapes.
The posterior incudal ligament is at risk during posterior tympanotomy (facial recess approach for cochlear implantation) — inadvertent disruption causes incus dislocation. In chronic ear disease, erosion of the incudal fossa destroys this ligament, leading to incus dislocation and conductive hearing loss.
Loss of posterior incudal support from ligament erosion or trauma producing ossicular chain discontinuity and maximum conductive hearing loss.
Chronic otitis media erosion of the incudal fossa destroying the posterior ligament attachment, a precursor to ossicular chain discontinuity.
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