A hybrid 3D-printed temporal bone simulator with simulated bleeding for otologic training

To develop and evaluate a novel biomimetic temporal bone simulator using a segmented, multi-material hybrid 3D-printing strategy with a setup for simulated bleeding.

A modular simulator was fabricated using stereolithography for the bony framework (including mastoid air cells), PolyJet full-color printing for key neuro-otologic structures (e.g., facial nerve, inner ear, ossicles), and WJP printing for soft tissues (e.g., auricle, tympanic membrane, vessels). A spring-driven syringe setup delivered blood-mimicking fluid to simulate sigmoid sinus bleeding during drilling. Eight senior otologists evaluated the simulator using a Likert 5-point scale.

The simulator successfully reproduced major anatomical landmarks and supported common otologic procedures. Manufacturing cost was approximately USD 80 per unit. Overall fidelity ratings were favorable, with most item means between 3.8 and 4.9. The facial nerve similarity item scored lower (mean 3.8 ± 0.71; 62.5% endorsement). Internal consistency was acceptable for fidelity (α = 0.63; 95% CI: 0.09-0.91) and good for perceived educational value(α = 0.90; 95% CI: 0.74-0.98). All perceived educational value items were rated between 3.8 and 4.7.

A biomimetic, modular temporal bone simulator produced via a segmented multi-material hybrid 3D-printing strategy demonstrated favorable expert-rated realism and perceived educational value. The incorporation of simulated bleeding may enhance training relevance. This platform may serve as a potential adjunct to cadaveric training for stepwise skill acquisition and complication management rehearsal in otology.