A dress rehearsal for surgery

UNC School of Medicine and NC State researchers create 3D-printed models of temporal bones to be used for surgical simulation in pediatric cases and for patients with unusual anatomy.

Austin Rose, MD/Photo by Max Englund, UNC Health Care.
Ola Harrysson, PhD/Photo by Max Englund, UNC Health Care.

A few years ago, UNC’s Austin Rose, MD, associate professor of Otolaryngology-Head & Neck Surgery, imagined a temporal bone model that could be used to teach surgical skills to residents in a lab.  He knew the anatomy of the ear inside out, but he needed an expert in the field of 3D printing to make this model come to life in a relatively inexpensive and reproducible way.

At a conference, Rose found a partner who happened to be located just down road in Raleigh. Ola Harrysson, PhD, professor of Industrial and Systems Engineering at NC State University, was at the forefront of 3D printing for all kinds of applications, and he had experience developing bone models and implants for veterinary medicine.  

Together, through many iterations, Rose, Harrysson and Caroline Webster, an NC State graduate student, have created a 3D printed model of the temporal bone that can be used not only for general surgical skills training, but is so precise it can be used to simulate challenging surgeries for specific patients. The model replicates hard bone, but also incorporates soft tissue structures like nerves, arteries and veins. Avoiding damage to such vital structures is essential for a good surgery outcome.

A model prepared for a specific patient, 12-year-old Eric from Wilmington, NC, was used for the first time earlier this year. A longtime patient at UNC, Eric underwent surgery to remove a benign tumor of the ear known as cholesteatoma. It was a procedure he had gone through multiple times before because of the nature of the disease. This time, his doctors had the benefit of using a highly-accurate replica of his temporal bone pre-operatively, and Eric got a better picture of what would go on during that surgery.

The group authored an article about the surgical simulation, “Pre-operative simulation of pediatric mastoid surgery with 3D-printed temporal bone models,” in the journal International Journal of Pediatric Otorhinolaryngology in March 2015. In February 2015, Annals of Otology, Rhinology, and Laryngology published a paper, “Multi-material 3D Models for Temporal Bone Surgical Simulation,” related to the creation of a model that incorporates hard and soft structures in a 3D model.

Watch our video, "Engineering a Better Surgery" to see how Rose, Harrysson and Webster used a CT scan, a software program, and a 3D printer to build the most realistic model possible to prepare for surgery. Learn more about Eric’s experience as the first UNC patient to have his temporal bone scanned and turned into a 3D model in the video, "A Model Patient."

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