{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:16:16Z","timestamp":1788315376839,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["0084895"],"award-info":[{"award-number":["0084895"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if intraoperative inspection of patient\u2010specific 3D\u2010printed TB models, as a supplement to standard imaging, affects the cognitive load of surgeons during cochlear implantation (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized controlled trial included 40 consecutive adult primary CI surgeries performed by seven attending and five trainee surgeons at a large CI center. Cases were randomized 1:1 to current standard with surgical planning based on imaging review (controls) or to current standard plus intra\u2010operative inspection of a 3D\u2010printed model (intervention). The primary outcome, intraoperative cognitive load, was measured using the Surgery Task Load Index (Surg\u2010TLX) and analyzed with linear mixed\u2010effects models. Secondary outcomes included ratings of model anatomy, utility, and user experience (Schlegel\u2010questionnaire) and prediction of intraoperative challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Attending surgeons experienced lower overall cognitive load using 3D models versus controls (3.8 vs. 5.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), driven by reduced physical fatigue (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Conversely, residents reported higher overall load (7.2 vs. 4.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) with increased mental (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and physical fatigue (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Fellows showed no significant difference in overall load (8.2 vs. 8.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.88) but noted lower case complexity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) offset by higher physical fatigue (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Models were viewed as accurate and useful, particularly for trainee education, anticipating case difficulty and anatomical boundaries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The clinical impact of intraoperative 3D\u2010printed models during CI is modulated by surgical experience. For attendings, models act as high\u2010fidelity references facilitating cognitive offloading, whereas they stimulate mental effort for trainees. Selective implementation is recommended to align use of models to surgical experience level to promote operative efficiency and surgical training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70887","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:44:47Z","timestamp":1788313487000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Intraoperative Patient\u2010Specific\n                    <scp>3D<\/scp>\n                    \u2010Printed Temporal Bones: A Randomized Controlled Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5360-0515","authenticated-orcid":false,"given":"Adam","family":"Omari","sequence":"first","affiliation":[{"name":"Copenhagen Hearing and Balance Center, Department of Otolaryngology\u2013Head and Neck Surgery Rigshospitalet, Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Institute for Cellular and Molecular Medicine (ICMM), Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, RegionH  Copenhagen Denmark"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0886-1561","authenticated-orcid":false,"given":"Obinna I.","family":"Nwosu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A. W.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Copenhagen Hearing and Balance Center, Department of Otolaryngology\u2013Head and Neck Surgery Rigshospitalet, Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, RegionH  Copenhagen Denmark"},{"name":"Department of Clinical Medicine (ICM), Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4075-0960","authenticated-orcid":false,"given":"Alicia M.","family":"Quesnel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.22580"},{"key":"e_1_2_11_3_1","unstructured":"World\u2010Health\u2010Organization (WHO) \u201cWorld Report on Hearing \u201dCC BY\u2013NC\u2013SA 3.0 IGO https:\/\/apps.who.int\/iris\/rest\/bitstreams\/1334317\/retrieve2021."},{"key":"e_1_2_11_4_1","unstructured":"MED\u2010EL \u201cFDA Approves MED\u2010EL USA's Cochlear Implants for Single\u2010Sided Deafness and Asymmetric Hearing Loss \u201d(2019) https:\/\/www.medel.com\/en\u2010us\/press\u2010room\/press\u2010list\/press\u2010details\/2019\/07\/22\/fda\u2010approves\u2010med\u2010el\u2010usa\u2010s\u2010cochlear\u2010implants\u2010for\u2010single\u2010sided\u2010deafness\u2010and\u2010asymmetric\u2010hearing\u2010loss."},{"issue":"45","key":"e_1_2_11_5_1","article-title":"Cochlear Implantation for Adults","volume":"182","author":"West N.","year":"2020","journal-title":"Ugeskrift for Laeger"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2017.05.006"},{"key":"e_1_2_11_7_1","volume-title":"StatPearls","author":"Kennedy K. 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