Current status of 3D-printed human ossicles: a systematic review

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: = 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.