{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:55:51Z","timestamp":1787936151422,"version":"build-2784847793"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum W\u00fcrzburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study evaluates the imaging quality and radiation dose of six flat-panel volume CT protocols with varying technical parameters, including examination time (\u201cArtis Icono\u201d angiography system (Siemens Healthcare AG, Erlangen, Germany): 14s DCT HEAD MICRO CARE (14s I), 14s DCT HEAD MICRO CARE 4 (14s II), 8s DCT HEAD 70kV CARE 1 (8s I), 8s DCT HEAD 70kV CARE 3 (8s II), 4s DCT HEAD CARE FB (4s I), 4s DCT HEAD CARE FB 2 (4s II)) for middle ear visualization in human skull specimens. A scoring system assessed the delineation of 28 anatomical structures, narrowed to eight for detailed evaluation. Protocols 14s I and 8s I achieved the highest image quality, exceeding the clinical threshold. 8s I protocol demonstrated an optimal balance between image quality and radiation safety, adhering to the ALADA principle (\u201cas low as diagnostically acceptable\u201d). While 14s I offered superior detail, it involved higher radiation exposure without substantial further image improvement, indicating a saturation effect. Shorter protocols, such as 4s I, offered radiation-sparing advantages but did not consistently meet clinical image quality standards. Protocol 8s I is recommended as the standard for middle ear imaging, with 4s I as a potential alternative for cases requiring minimized radiation exposure and reduced motion artifact susceptibility.<\/jats:p>","DOI":"10.1038\/s41598-025-33592-5","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T16:38:09Z","timestamp":1767631089000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative evaluation of flat-panel volume CT protocols for high-resolution visualization of middle ear anatomy in human skull specimens"],"prefix":"10.1038","volume":"16","author":[{"given":"Franz-Tassilo","family":"M\u00fcller-Graff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"von D\u00fcring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjoern","family":"Spahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Weick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Richter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Peter","family":"Grunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilmann","family":"Neun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Hackenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Rak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"33592_CR1","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1002\/lary.25659","volume":"126","author":"M Tamplen","year":"2016","unstructured":"Tamplen, M., Schwalje, A., Lustig, L., Alemi, A. S. & Miller, M. E. Utility of preoperative computed tomography and magnetic resonance imaging in adult and pediatric cochlear implant candidates. Laryngoscope 126, 1440\u20131445. https:\/\/doi.org\/10.1002\/lary.25659 (2016).","journal-title":"Laryngoscope"},{"key":"33592_CR2","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s13244-020-00902-6","volume":"11","author":"G Widmann","year":"2020","unstructured":"Widmann, G., Dejaco, D., Luger, A. & Schmutzhard, J. Pre- and post-operative imaging of cochlear implants: a pictorial review. Insights Imaging 11, 93. https:\/\/doi.org\/10.1186\/s13244-020-00902-6 (2020).","journal-title":"Insights Imaging"},{"key":"33592_CR3","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1097\/01.mao.0000185049.61770.da","volume":"26","author":"DA Parry","year":"2005","unstructured":"Parry, D. A., Booth, T. & Roland, P. S. Advantages of magnetic resonance imaging over computed tomography in preoperative evaluation of pediatric cochlear implant candidates. Otol. Neurotol. 26, 976\u2013982. https:\/\/doi.org\/10.1097\/01.mao.0000185049.61770.da (2005).","journal-title":"Otol. Neurotol."},{"key":"33592_CR4","doi-asserted-by":"crossref","unstructured":"K\u00f6sling S, H. K., Bootz F, Czerny C, Greess H, Krombach GA, et al. Bildgebung HNO-Heilkunde. 2. Auflage. K\u00f6sling S, Bootz F, (eds.) (Springer, 2014).","DOI":"10.1007\/978-3-642-45133-1"},{"key":"33592_CR5","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1007\/s00405-016-4345-2","volume":"274","author":"C Guldner","year":"2017","unstructured":"Guldner, C. et al. Visualization of anatomy in normal and pathologic middle ears by cone beam CT. Eur. Arch. Otorhinolaryngol. 274, 737\u2013742. https:\/\/doi.org\/10.1007\/s00405-016-4345-2 (2017).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"33592_CR6","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1118\/1.3395578","volume":"37","author":"RL Dixon","year":"2010","unstructured":"Dixon, R. L. & Boone, J. M. Cone beam CT dosimetry: A unified and self-consistent approach including all scan modalities\u2013with or without phantom motion. Med. Phys. 37, 2703\u20132718. https:\/\/doi.org\/10.1118\/1.3395578 (2010).","journal-title":"Med. Phys."},{"key":"33592_CR7","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/s0895-6111(02)00008-3","volume":"26","author":"R Baba","year":"2002","unstructured":"Baba, R., Konno, Y., Ueda, K. & Ikeda, S. Comparison of flat-panel detector and image-intensifier detector for cone-beam CT. Comput. Med. Imaging Graph 26, 153\u2013158. https:\/\/doi.org\/10.1016\/s0895-6111(02)00008-3 (2002).","journal-title":"Comput. Med. Imaging Graph"},{"key":"33592_CR8","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1259\/dmfr\/19164138","volume":"36","author":"SH Bartling","year":"2007","unstructured":"Bartling, S. H. et al. Large scan field, high spatial resolution flat-panel detector based volumetric CT of the whole human skull base and for maxillofacial imaging. Dentomaxillofac Radiol. 36, 317\u2013327. https:\/\/doi.org\/10.1259\/dmfr\/19164138 (2007).","journal-title":"Dentomaxillofac Radiol."},{"key":"33592_CR9","doi-asserted-by":"publisher","first-page":"2767","DOI":"10.1007\/s00330-007-0651-9","volume":"17","author":"WA Kalender","year":"2007","unstructured":"Kalender, W. A. & Kyriakou, Y. Flat-detector computed tomography (FD-CT). Eur. Radiol. 17, 2767\u20132779. https:\/\/doi.org\/10.1007\/s00330-007-0651-9 (2007).","journal-title":"Eur. Radiol."},{"key":"33592_CR10","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1007\/s00117-009-1861-8","volume":"49","author":"T Struffert","year":"2009","unstructured":"Struffert, T. & Doerfler, A. Flat-detector computed tomography in diagnostic and interventional neuroradiology. Radiologe 49, 820\u2013829. https:\/\/doi.org\/10.1007\/s00117-009-1861-8 (2009).","journal-title":"Radiologe"},{"key":"33592_CR11","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1007\/s00405-021-06924-0","volume":"279","author":"FT M\u00fcller-Graff","year":"2022","unstructured":"M\u00fcller-Graff, F. T. et al. Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation. Eur. Arch. Otorhinolaryngol. 279, 2309\u20132319. https:\/\/doi.org\/10.1007\/s00405-021-06924-0 (2022).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"33592_CR12","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1080\/14670100.2022.2159128","volume":"24","author":"FT M\u00fcller-Graff","year":"2023","unstructured":"M\u00fcller-Graff, F. T. et al. Accuracy of radiological prediction of electrode position with otological planning software and implications of high-resolution imaging. Cochlear Implants Int. 24, 1\u201311. https:\/\/doi.org\/10.1080\/14670100.2022.2159128 (2023).","journal-title":"Cochlear Implants Int."},{"key":"33592_CR13","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1080\/14670100.2021.1973208","volume":"23","author":"P Schendzielorz","year":"2022","unstructured":"Schendzielorz, P. et al. Precise evaluation of the postoperative cochlear duct length by flat-panel volume computed tomography\u2014Application of secondary reconstructions. Cochlear Implants Int. 23, 32\u201342. https:\/\/doi.org\/10.1080\/14670100.2021.1973208 (2022).","journal-title":"Cochlear Implants Int."},{"key":"33592_CR14","first-page":"143","volume":"13","author":"M Panjnoush","year":"2016","unstructured":"Panjnoush, M. et al. Effect of exposure parameters on metal artifacts in cone beam computed tomography. J. Dent. 13, 143\u2013150 (2016).","journal-title":"J. Dent."},{"key":"33592_CR15","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1148\/radiol.2303021726","volume":"230","author":"MK Kalra","year":"2004","unstructured":"Kalra, M. K. et al. Strategies for CT radiation dose optimization. Radiology 230, 619\u2013628. https:\/\/doi.org\/10.1148\/radiol.2303021726 (2004).","journal-title":"Radiology"},{"key":"33592_CR16","doi-asserted-by":"publisher","first-page":"20150078","DOI":"10.1259\/dmfr.20150078","volume":"44","author":"R Pauwels","year":"2015","unstructured":"Pauwels, R., Faruangsaeng, T., Charoenkarn, T., Ngonphloy, N. & Panmekiate, S. Effect of exposure parameters and voxel size on bone structure analysis in CBCT. Dentomaxillofac. Radiol. 44, 20150078. https:\/\/doi.org\/10.1259\/dmfr.20150078 (2015).","journal-title":"Dentomaxillofac. Radiol."},{"key":"33592_CR17","doi-asserted-by":"publisher","first-page":"752","DOI":"10.2214\/AJR.20.23157","volume":"216","author":"I Burck","year":"2021","unstructured":"Burck, I. et al. Radiohistologic comparison study of temporal bone specimens after cochlear implant electrode array insertion: Is cone-beam CT superior to MDCT?. AJR Am. J. Roentgenol. 216, 752\u2013758. https:\/\/doi.org\/10.2214\/AJR.20.23157 (2021).","journal-title":"AJR Am. J. Roentgenol."},{"key":"33592_CR18","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1007\/s00234-022-02940-x","volume":"64","author":"F Eisenhut","year":"2022","unstructured":"Eisenhut, F. et al. High-speed flat-detector computed tomography for temporal bone imaging and postoperative control of cochlear implants. Neuroradiology 64, 1437\u20131445. https:\/\/doi.org\/10.1007\/s00234-022-02940-x (2022).","journal-title":"Neuroradiology"},{"key":"33592_CR19","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1007\/s00405-019-05726-9","volume":"277","author":"K Reimann","year":"2020","unstructured":"Reimann, K., Hirt, B. & Schulze, M. Image quality of flat-panel computed tomography using 2 different acquisition times versus multidetector computed tomography in whole-head temporal bone specimen. Eur. Arch. Otorhinolaryngol. 277, 415\u2013422. https:\/\/doi.org\/10.1007\/s00405-019-05726-9 (2020).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"33592_CR20","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/01.mao.0000194816.15298.50","volume":"27","author":"SH Bartling","year":"2006","unstructured":"Bartling, S. H. et al. Flat-panel volume computed tomography for cochlear implant electrode array examination in isolated temporal bone specimens. Otol. Neurotol. 27, 491\u2013498. https:\/\/doi.org\/10.1097\/01.mao.0000194816.15298.50 (2006).","journal-title":"Otol. Neurotol."},{"key":"33592_CR21","first-page":"1417","volume":"25","author":"R Gupta","year":"2004","unstructured":"Gupta, R. et al. Experimental flat-panel high-spatial-resolution volume CT of the temporal bone. AJNR Am. J. Neuroradiol. 25, 1417\u20131424 (2004).","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"33592_CR22","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s00405-006-0180-1","volume":"264","author":"C Offergeld","year":"2007","unstructured":"Offergeld, C. et al. Rotational tomography of the normal and reconstructed middle ear in temporal bones: an experimental study. Eur. Arch. Otorhinolaryngol. 264, 345\u2013351. https:\/\/doi.org\/10.1007\/s00405-006-0180-1 (2007).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"33592_CR23","doi-asserted-by":"publisher","first-page":"e893","DOI":"10.1097\/MAO.0000000000002483","volume":"41","author":"TF Jakob","year":"2020","unstructured":"Jakob, T. F. et al. Virtual quality control in middle ear surgery: Is image-guided tympanoscopy a valuable tool for depicting borderline situations?. Otol. Neurotol. 41, e893\u2013e900. https:\/\/doi.org\/10.1097\/MAO.0000000000002483 (2020).","journal-title":"Otol. Neurotol."},{"key":"33592_CR24","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.3174\/ajnr.A1560","volume":"30","author":"O Majdani","year":"2009","unstructured":"Majdani, O. et al. Temporal bone imaging: comparison of flat panel volume CT and multisection CT. AJNR Am J Neuroradiol 30, 1419\u20131424. https:\/\/doi.org\/10.3174\/ajnr.A1560 (2009).","journal-title":"AJNR Am J Neuroradiol"},{"key":"33592_CR25","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s00330-011-2317-x","volume":"22","author":"K Zaoui","year":"2012","unstructured":"Zaoui, K. et al. Flat panel CT following stapes prosthesis insertion: an experimental and clinical study. Eur. Radiol. 22, 837\u2013844. https:\/\/doi.org\/10.1007\/s00330-011-2317-x (2012).","journal-title":"Eur. Radiol."},{"key":"33592_CR26","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1007\/s00330-009-1582-4","volume":"20","author":"A Bozzato","year":"2010","unstructured":"Bozzato, A., Struffert, T., Hertel, V., Iro, H. & Hornung, J. Analysis of the accuracy of high-resolution computed tomography techniques for the measurement of stapes prostheses. Eur. Radiol. 20, 566\u2013571. https:\/\/doi.org\/10.1007\/s00330-009-1582-4 (2010).","journal-title":"Eur. Radiol."},{"key":"33592_CR27","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1055\/s-0032-1325343","volume":"184","author":"M Kn\u00f6rgen","year":"2012","unstructured":"Kn\u00f6rgen, M., Brandt, S. & Kosling, S. Comparison of quality on digital X-ray devices with 3D-capability for ENT-clinical objectives in imaging of temporal bone and paranasal sinuses. Rofo 184, 1153\u20131160. https:\/\/doi.org\/10.1055\/s-0032-1325343 (2012).","journal-title":"Rofo"},{"key":"33592_CR28","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1055\/s-0029-1245709","volume":"183","author":"Y Kyriakou","year":"2011","unstructured":"Kyriakou, Y., Kolditz, D., Langner, O., Krause, J. & Kalender, W. Digital volume tomography (DVT) and multislice spiral CT (MSCT): an objective examination of dose and image quality. Rofo 183, 144\u2013153. https:\/\/doi.org\/10.1055\/s-0029-1245709 (2011).","journal-title":"Rofo"},{"key":"33592_CR29","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.3174\/ajnr.A5302","volume":"38","author":"G Conte","year":"2017","unstructured":"Conte, G. et al. Flat panel angiography in the cross-sectional imaging of the temporal bone: assessment of image quality and radiation dose compared with a 64-section multisection CT scanner. AJNR Am. J. Neuroradiol. 38, 1998\u20132002. https:\/\/doi.org\/10.3174\/ajnr.A5302 (2017).","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"33592_CR30","doi-asserted-by":"publisher","first-page":"362","DOI":"10.3174\/ajnr.A6894","volume":"42","author":"RA Helal","year":"2021","unstructured":"Helal, R. A. et al. Cone-beam CT versus multidetector CT in postoperative cochlear implant imaging: Evaluation of image quality and radiation dose. AJNR Am. J. Neuroradiol. 42, 362\u2013367. https:\/\/doi.org\/10.3174\/ajnr.A6894 (2021).","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"33592_CR31","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s00117-013-2644-9","volume":"54","author":"MK Pein","year":"2014","unstructured":"Pein, M. K., Brandt, S., Plontke, S. K. & Kosling, S. Visualization of subtle temporal bone structures. Comparison of cone beam CT and MDCT. Radiologe 54, 271\u2013278. https:\/\/doi.org\/10.1007\/s00117-013-2644-9 (2014).","journal-title":"Radiologe"},{"key":"33592_CR32","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1007\/s00330-013-3068-7","volume":"24","author":"K Zaoui","year":"2014","unstructured":"Zaoui, K. et al. Clinical investigation of flat panel CT following middle ear reconstruction: A study of 107 patients. Eur. Radiol. 24, 587\u2013594. https:\/\/doi.org\/10.1007\/s00330-013-3068-7 (2014).","journal-title":"Eur. Radiol."},{"key":"33592_CR33","doi-asserted-by":"publisher","first-page":"e294","DOI":"10.1097\/MAO.0000000000002951","volume":"42","author":"P Schendzielorz","year":"2021","unstructured":"Schendzielorz, P. et al. Precise evaluation of the cochlear duct length by flat-panel volume computed tomography (fpVCT)-implication of secondary reconstructions. Otol. Neurotol. 42, e294\u2013e303. https:\/\/doi.org\/10.1097\/MAO.0000000000002951 (2021).","journal-title":"Otol. Neurotol."},{"key":"33592_CR34","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.3390\/diagnostics11101894","volume":"11","author":"B Kofler","year":"2021","unstructured":"Kofler, B. et al. ALADA dose optimization in the computed tomography of the temporal bone: The diagnostic potential of different low-dose CT protocols. Diagnostics 11, 1894. https:\/\/doi.org\/10.3390\/diagnostics11101894 (2021).","journal-title":"Diagnostics"},{"key":"33592_CR35","doi-asserted-by":"publisher","first-page":"443","DOI":"10.3109\/00016480903292700","volume":"130","author":"T Struffert","year":"2010","unstructured":"Struffert, T. et al. Imaging of cochlear implant electrode array with flat-detector CT and conventional multislice CT: Comparison of image quality and radiation dose. Acta Otolaryngol. 130, 443\u2013452. https:\/\/doi.org\/10.3109\/00016480903292700 (2010).","journal-title":"Acta Otolaryngol."},{"key":"33592_CR36","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.3174\/ajnr.A2524","volume":"32","author":"CB Nauer","year":"2011","unstructured":"Nauer, C. B. et al. Low-dose temporal bone CT in infants and young children: Effective dose and image quality. AJNR Am. J. Neuroradiol. 32, 1375\u20131380. https:\/\/doi.org\/10.3174\/ajnr.A2524 (2011).","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"33592_CR37","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00234-011-0961-0","volume":"54","author":"CB Nauer","year":"2012","unstructured":"Nauer, C. B. et al. Radiation dose optimization in pediatric temporal bone computed tomography: Influence of tube tension on image contrast and image quality. Neuroradiology 54, 247\u2013254. https:\/\/doi.org\/10.1007\/s00234-011-0961-0 (2012).","journal-title":"Neuroradiology"},{"key":"33592_CR38","doi-asserted-by":"publisher","first-page":"e683","DOI":"10.1097\/MAO.0000000000001927","volume":"39","author":"AE Mekabaty","year":"2018","unstructured":"Mekabaty, A. E., Pross, S. E., Martinez, M., Carey, J. P. & Pearl, M. S. Reducing radiation dose for high-resolution flat-panel CT Imaging of superior semicircular canal dehiscence. Otol. Neurotol. 39, e683\u2013e690. https:\/\/doi.org\/10.1097\/MAO.0000000000001927 (2018).","journal-title":"Otol. Neurotol."},{"key":"33592_CR39","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.3174\/ajnr.A3814","volume":"35","author":"MS Pearl","year":"2014","unstructured":"Pearl, M. S., Roy, A. & Limb, C. High-resolution secondary reconstructions with the use of flat panel CT in the clinical assessment of patients with cochlear implants. Am. J. Neuroradiol. 35, 1202\u20131208 (2014).","journal-title":"Am. J. Neuroradiol."},{"key":"33592_CR40","volume-title":"Strahlenphysik, Dosimetrie und Strahlenschutz","author":"H Krieger","year":"2002","unstructured":"Krieger, H. Strahlenphysik, Dosimetrie und Strahlenschutz (Springer, 2002)."},{"key":"33592_CR41","doi-asserted-by":"crossref","unstructured":"Krieger, H. Strahlungsmessung und Dosimetrie. 2. Auflage (ed. Ingolstadt: SpringerSpektrum, 2012).","DOI":"10.1007\/978-3-658-00386-9"},{"key":"33592_CR42","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-7091-9188-0","volume-title":"Klinische Anatomie des Ohres","author":"J Lang","year":"1992","unstructured":"Lang, J. Klinische Anatomie des Ohres (Springer, 1992)."},{"key":"33592_CR43","volume-title":"Anatomie","author":"T Schiebler","year":"2004","unstructured":"Schiebler, T. Anatomie (Springer, 2004)."},{"key":"33592_CR44","unstructured":"Paulsen, F., Waschke, J. Sobotta, Atlas der Anatomie des Menschen, Kopf, Hals und Neuroanatomie. 23. Auflage. Uraban & Fischer Verlag (eds.). (2010)."},{"key":"33592_CR45","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1007\/s00234-013-1177-2","volume":"55","author":"H Frenzel","year":"2013","unstructured":"Frenzel, H. et al. Grading system for the selection of patients with congenital aural atresia for active middle ear implants. Neuroradiology 55, 895\u2013911. https:\/\/doi.org\/10.1007\/s00234-013-1177-2 (2013).","journal-title":"Neuroradiology"},{"key":"33592_CR46","doi-asserted-by":"publisher","first-page":"205846012110614","DOI":"10.1177\/20584601211061444","volume":"10","author":"M Fujiwara","year":"2021","unstructured":"Fujiwara, M. et al. Improved visualization of the chorda tympani nerve using ultra-high-resolution computed tomography. Acta Radiol. Open 10, 20584601211061444. https:\/\/doi.org\/10.1177\/20584601211061444 (2021).","journal-title":"Acta Radiol. Open"},{"key":"33592_CR47","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1111\/1754-9485.12596","volume":"61","author":"A Tada","year":"2017","unstructured":"Tada, A., Sato, S., Masaoka, Y. & Kanazawa, S. Imaging of the temporal bone in children using low-dose 320-row area detector computed tomography. J. Med. Imaging Radiat. Oncol. 61, 489\u2013493. https:\/\/doi.org\/10.1111\/1754-9485.12596 (2017).","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"33592_CR48","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/j.mri.2012.05.001","volume":"30","author":"A Fedorov","year":"2012","unstructured":"Fedorov, A. et al. 3D Slicer as an image computing platform for the quantitative Imaging Network. Magn. Reson. Imaging 30, 1323\u20131341. https:\/\/doi.org\/10.1016\/j.mri.2012.05.001 (2012).","journal-title":"Magn. Reson. Imaging"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33592-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33592-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33592-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:55:48Z","timestamp":1767707748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33592-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["33592"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-33592-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]},"assertion":[{"value":"3 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The anatomical specimens were supplied by the Anatomical Institute of our university to the Department of Oto-Rhino-Laryngology, Head and Neck Surgery at the University Hospital Wuerzburg, Germany, for educational and research purposes. The local ethics committee approved this study (ID: 2020111704). The body donors had provided written informed consent during their lifetime to be included in experimental research; therefore, no additional written informed consent was required. During all examinations, ethical protocols were strictly followed in compliance with state and federal laws and the principles of the \u201cWMA Declaration of Helsinki on Ethical Principles for Research Involving Human Subjects\u201d, ensuring the proper acquisition and use of human specimens.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and informed consent"}}],"article-number":"629"}}