Surgeons' perspectives on patient-specific 3D-printed temporal bone models: What do we need?

Patient-specific 3D-printed temporal-bone (PS-TB) models may improve rehearsal, planning and navigation in temporal-bone surgery, yet their optimal use-cases, required fidelity, and desirable enhancements remain undefined from the surgeon's perspective. The purpose is to investigate surgeons' preferred use-cases, physical resemblance requirements, and valuable enhancements for PS-TB models.

Otosurgeons from national and international societies were surveyed in the period December 2024-April 2025. Respondents were stratified into either high-volume (HV) surgeons defined as performing ≥50 mastoidectomies per year or low-volume (LV) surgeons. The survey consisted of 88 questions comprising Likert-scale rating (1-5) and free-text responses. Group means were compared with Welch t-tests.

Of the 87 participating surgeons, 69 completed the questionnaire (79% response rate; 55 LV/32 HV). PS-TB models were perceived most clinically relevant for pre-operative rehearsal in cases of anatomical malformation (4.14 LV vs 3.62 HV) and least relevant in tympanoplasty and stapes surgical cases. Overall mean perceived pre-operative relevance across procedures was higher for LV than HV surgeons (2.80 vs 2.36; p < 0.01). The same was found for intraoperative use (2.67 vs 2.30; p < 0.05). Critical anatomical landmark structures should have sub-millimeter precision, in particular the facial nerve and lateral semicircular canal (≥4.3). Model enhancements that support visualization of critical structures are rated likely to add clinical value.

Otosurgeons perceive PS-TB models as a relevant tool for cases of malformed anatomy or otherwise complex surgery, especially among LV surgeons. However, models need to replicate critical landmarks with sub-millimeter accuracy. These requirements define a trajectory towards improving model value for clinicians.