Abstract
Background
Three-dimensional (3D) printed ossicle models may be useful in education and clinical practice, but accurate replication remains challenging.Aim
To systematically review 3D-printed ossicles to map replication methods, factors influencing accuracy, and suggest needed innovations for higher accuracy.Methods
PubMed, Embase, Scopus, and Web of Science were searched from inception through June 2025. Two reviewers independently screened for final inclusion. Data on imaging, segmentation, 3D-printing-technology, materials, and post-processing were extracted. Educational studies were appraised using the Medical Education Research Study Quality Instrument. A panel of otosurgeons rated ossicle images for realism and visualization.Results
Sixty-five studies were included. Most models embedded ossicles in healthy temporal-bones (n = 46), with fewer pathological (n = 6) or stand-alone models (n = 13). Stapes was often absent or poorly reproduced, whereas malleus and incus were usually recognizable. Higher realism was associated with micro-CT or cone-beam-CT combined with stereolithography or PolyJet-printing. These photopolymer-based technologies allowed ossicle mobility in selected models. However, reporting of replication methods and anatomical accuracy was often limited, constraining deeper comparison between studies.Conclusions and significance
Accurate ossicle replication is emerging but depends on optimization of imaging, processing, and 3D-printing. Standardized reporting is needed to improve comparison between methods and support use in training and reconstruction.