The foramen of Huschke (FH) and the petrotympanic fissure (PTF) are anatomical structures that can influence temporomandibular joint disorders (TMD) by potentially affecting the movement and function of the mandibular condyle. This study investigates the relationship between patients with TMD and the presence of FH and PTF to enhance diagnostic and therapeutic approaches. This retrospective study analyzed cone beam computed tomography (CBCT) images from 212 patients. Patients were categorised into TMD and control groups based on standardized DC/TMD protocols. An observer, blinded to the patient's clinical status, then analyzed the CBCT images. The CBCT images were evaluated for the presence and characteristics of FH, PTF, and condyle shape and position. A higher incidence of FH and PTF was observed in patients with TMD than in the control group. FH was present on the right side in 33.3% of patients with TMD and 18% of controls and on the left side in 23.8% of patients with TMD and 10.9% of controls. Open and semi-open FPT statistically differed between the TMD and control groups (p < 0.05). The length of FH in patients with TMD was significantly larger (2.11 ± 0.44 mm) than in the controls (1.67 ± 0.56 mm). The position of the condyle showed a statistically significant difference between the groups (p < 0.05). FH and PTF subtypes are significantly associated with TMD, underscoring their importance in clinical practice.
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