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Related Experiment Video

Updated: Nov 21, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
09:07

Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration

Published on: January 26, 2024

3.0K

Precision Medicine in Ossiculoplasty.

Payal Mukherjee1, Kai Cheng1, Johnson Chung2

  • 1RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|January 14, 2021
PubMed
Summary

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Accurate 3D printing of ossicles for reconstructive surgery is possible with modern imaging. Conebeam CT and laser-based 3D printing offer the best results for precise anatomical replication.

Area of Science:

  • Biomedical Engineering
  • Otolaryngology
  • Medical Imaging

Background:

  • Ossiculoplasty surgery outcomes are often poor due to graft displacement and extrusion.
  • Current digital methods for 3D morphological studies of ossicular anatomy are limited by clinical imaging resolution.
  • Three-dimensional (3D) printing holds promise for improving ossiculoplasty, but requires accurate anatomical data.

Purpose of the Study:

  • To determine the minimum resolution required for accurate 3D reconstruction of ossicular anatomy using clinical imaging.
  • To compare the accuracy of different CT imaging modalities (conebeam CT, helical CT) for 3D ossicular analysis.
  • To evaluate the efficacy of different 3D printing techniques for creating patient-specific ossicular prostheses.

Main Methods:

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  • 20 human cadaveric temporal bones were scanned using micro computed tomography (CT) (40 µm resolution) as a reference.
  • Bones were subsequently scanned using conebeam CT (125 µm) and helical CT (0.6 mm).
  • Three-dimensional reconstructions were generated, and two 3D printing methods (laser-based and extrusion-based) were assessed for incus replication.

    • Main Results:

    • A minimum resolution of 100 µm is necessary for adequate 3D reconstruction of the ossicular chain.
    • Conebeam CT provided the most accurate 3D morphological data, with the smallest mean variation compared to microCT.
    • Laser-based 3D printing was superior to extrusion-based printing for achieving the required resolution for ossicular prostheses. Contralateral incus anatomy can be used if the ipsilateral is missing.

    Conclusions:

    • Modern imaging resolutions are sufficient for accurate 3D reconstruction and 3D printing of human ossicles.
    • Careful attention to thresholding during the 3D reconstruction process is crucial for optimal results.
    • These advancements pave the way for improved patient-specific implants in ossiculoplasty, potentially enhancing surgical outcomes.