Soft Tissue Morphometry of the Malleus–Incus Complex from Micro-CT Imaging

The malleus–incus complex (MIC) is unique to mammalian hearing. To develop a comprehensive biomechanical MIC model for the human middle ear, measurements regarding its anatomical features are a necessity. Micro-scale X-ray computed tomography (micro-CT) imaging, which is known to be a suitable method for imaging high-density tissue such as middle-ear ossicles and surrounding bones, is used in this study to determine the three-dimensional (3-D) morphometry of the soft tissue attachments of the MIC. The MIC morphometry is based on their 3-D reconstruction from micro-CT image slices with resolutions ranging from 10 to 20 μm. The suspensory ligament and tendon attachments of the malleus and the incus as well as the incudomalleal joint (IMJ), are quantified in terms of dimensions, positions, and orientations for four human cadaver temporal bones. The malleus principal frame, the incus principal frame, and the MIC principle frame are calculated and the morphometry is reported in relation to each of these frames for the first time. The resulting values show significant variation across ear samples, suggesting that models of the MIC should be based on individual anatomy. The IMJ morphometry dimensions appear to be proportional to the ossicular mass. The micro-CT imaging modality is a nondestructive and relatively fast method for obtaining soft tissue morphometry and provides accurate anatomical features in relation to the principal axes of bones.