A new physical temporal bone and middle ear model with complete ossicular chain for simulating surgical procedures

In this article, we present a new physical model for the surgical simulation of interventions in the middle ear and temporal bone. The goal of the work was to provide on one side a detailed and easy to use model for the training of stapes plastic surgeries and on the other side a realistic testing environment for a surgical robotic system formally presented of our group. The stapedotomy, a common stapes plastic, is an intervention at the middle ear to reconstruct the path of sound transmission using a small implant. It is performed, e.g., in case of a conductive hearing loss due to an otosclerosis, which is a disease of abnormal bone growth at the stapes, the smallest of the auditory ossicles. The training of the intervention is typically done at human preparations. However, there is a lack of reproducibility and availability. The presented new physical middle ear model allows to simulate the main steps of stapes plastics including the manipulation of bone structures and inserting a stapes-prosthesis. It contains of a detailed 3D printed temporal bone with a flexible and removable ossicular chain coming from high resolution μCT (micro computed tomography) data. Our experiments show, that it is possible to perform the main steps of the stapedotomy close to the real procedure. The anatomic structures are realistic enough for the purpose. As far as we know, it is the first physical model, with removable ossicles, as well as a modular auditory canal and middle ear area, for simulating the implantation of stapes-prosthesis fabricated by 3D printing.