Pathology-oriented 3d-printed temporal bone models for cholesteatoma surgery training with enhanced ossicular chain fidelity

Surgical simulation on 3D-printed anatomical models is an increasingly important tool for training in mastoidectomy and cholesteatoma surgery. Previous studies have demonstrated the possibility of obtaining accurate models of the temporal bone from CT images and 3D segmentation and printing processes. However, critical issues remain regarding the accurate reproduction of the ossicular chain and the reproducibility of millability behavior that is similar to that of human bone, as well as the need for pathological models dedicated to the simulation of specific clinical scenarios. We based our enhanced models of the temporal bone on two specialized pathological models: a right temporal bone with an epitympanic cholesteatoma that extended from the antral cell to the ossicular chain and a left temporal bone with a cholesteatoma that extended from the mastoid to the ossicular chain. The optimizations were intended to enhance the fidelity of delicate features and enhance milling performance in order to achieve a more realistic simulation. Advanced anatomical models with greater definition of the ossicular chain and two pathological models characterized by different extensions of the cholesteatoma were obtained and were designed to allow the surgical exploration and controlled removal of pathological tissue.