Three-dimensional modeling of the temporal bone for surgical training.
BACKGROUND
The anatomy of the temporal bone (TB) can only be mastered by repeated surgical and anatomic dissections, and surgical teaching initiative had a major effect on outcomes. The aim of this study was to investigate the validity of an artificial TB model devoted to surgical training and education.


METHODS
A helical computed tomographic (CT) scan was used to acquire high-resolution data of cadaveric TB. Digital imaging and communications in medicine (DICOM) data were converted into.stl files after data processing. Cadaveric TBs were prototyped using stereolithography. The validation of the prototype needed several steps. First of all, we have studied on CT scan the positional relationship between the facial nerve and other structures of the cadaveric TBs and prototyped bones. Otoendoscopy of the middle ear and the internal acoustic canal and visualization of anatomic landmarks during TB drilling of the cadaveric TBs and prototyped bones were also performed.


RESULTS
Seven normal CT scans of cadaveric TB were selected to make prototyped bone using stereolithography. Measurements of volume and distance showed no significant difference between prototypes and cadaver TBs. Classic mastoid surgical procedures were performed in the Anatomy Department: exposing sigmoid sinus, facial nerve, labyrinth, dura mater, jugular bulb, and internal carotid artery. Two simulations of implantable middle ear prosthesis were made successfully.


CONCLUSIONS
These prototypes made using stereolithography seem to be a good anatomic model for surgical training. This model could also be interesting for surgical planning in congenital ear anomalies before middle ear prosthesis implantation.
Bakhos
David
D
Service d'ORL et Chirurgie Cervico-Faciale, Tours, France. bakhos_d@med.univ-tours.fr
Velut
Stéphane
S
Robier
Alain
A
Al zahrani
Musaed
M
Lescanne
Emmanuel
E
D002102:Cadaver; D004423:Ear / Q000002:abnormalities / Q000601:surgery; D005154:Facial Nerve / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D008416:Mastoid / Q000033:anatomy & histology / Q000601:surgery; D008953:Models, Anatomic; D013506:Otologic Surgical Procedures / Q000193:education*; D019919:Prosthesis Implantation / Q000193:education; D015203:Reproducibility of Results; D013701:Temporal Bone / Q000033:anatomy & histology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000033:anatomy & histology / Q000601:surgery