The ovine temporal bone for otologic surgery training: a systematic review

Objective Otologic surgery requires detailed anatomical knowledge and advanced technical skills, making laboratory training relevant. The limited availability of human temporal bones has encouraged the development of alternative anatomical models. This systematic review evaluates the anatomical features, surgical access routes, and applicability of ovine temporal bone models for otologic surgical training. Design The authors conducted a systematic review across PubMed, SciELO, and Google Scholar databases. Eligible studies described anatomical findings based on microscopic or endoscopic dissection of ovine temporal bones and/or assessed their use for surgical training. Data on anatomy, surgical approaches, performed procedures, preservation methods, and participant profiles were extracted. The review followed PRISMA guidelines, and the protocol was registered in PROSPERO. Results Twenty-six studies met the inclusion criteria. Sheep middle- and inner-ear anatomy showed close correspondence with human structures. Retroauricular, transcanal, and retrosigmoid approaches were consistently described. A wide range of procedures including tympanoplasty, ossicular chain reconstruction, stapedotomy, facial nerve decompression, and cochlear implantation were reported using microscopic and endoscopic techniques. Studies reported reductions in operative time, improved technical accuracy, and increased participant confidence. The model was consistently described as low cost, generally available, and ethically acceptable when sourced from the food industry, although some anatomical differences from the human temporal bone have been reported. Conclusions The ovine temporal bone is a feasible and ethically acceptable model for otologic surgical training. Its anatomical realism supports a wide range of procedures, although anatomical differences should be considered when translating findings to human surgery. These findings support the incorporation of ovine temporal bone dissection into structured otologic surgical training programs.