Transparent 3D-Printed Temporal Bones for Precision Surgical Planning.
Peter Sudworth (NCIC), Tim Donovan (UoC), and Harry Tustin (NCIC)
A mastoidectomy is an operation performed to remove infection or disease from the bone containing the structures of the middle and inner ear (the temporal bone). It is commonly used to treat cholesteatoma, a destructive growth that can erode bone and damage hearing or balance. The operation involves using a surgical drill to carefully remove diseased bone while avoiding delicate structures such as the facial nerve, the inner ear, the base of the brain, and major blood vessels. If these structures are damaged, risks include permanent hearing loss, severe dizziness, and loss of movement of the muscles of the face.
The internal region of the temporal bone presents significant difficulty for surgeons and trainees, as accurately visualising the anatomical structures in three dimensions can be challenging. Additionally, because every patient’s anatomy is different, the operation demands precise pre-operative planning. This is particularly true for patients who have had a mastoid operation previously, and where usual surgical landmarks may be absent.
Mastoid surgery is working through a microscope inside an upside-down pyramid with a base barely two centimetres wide, surrounded by vital structures. A movement of just one millimetre can mean the difference between success and permanent injury.
Our project aims to improve the pre-operative planning process in mastoid surgery by developing transparent 3D-printed models of the temporal bone. These models, made directly from patients’ CT scans, will allow surgeons to see key internal structures in colour and in three dimensions before operating. This provides a more intuitive, hands-on way to understand each patient’s anatomy compared with viewing flat CT images alone.
We are inviting experienced ENT surgeons and trainees to take part in a short study to evaluate these models and compare their effectiveness with conventional CT imaging. We will test whether these transparent models help surgeons plan operations more safely and efficiently, and whether they improve confidence and accuracy in simulated surgery. Importantly we will objectively validate surgeon performance during simulations using hand movement tracking technology to help us understand and measure improvement.
We are working with a community group to establish if these models aid communication with patients and other members of the public.
If successful, this technology could become a routine part of preparing for complex ear operations across the NHS, reducing surgical risk and improving outcomes for patients. Such an approach could help reduce complications and improve outcomes for patients undergoing complex ear surgery.