INTRODUCTION: Three-dimensional (3D) tools have played a significant role in advancing anatomical knowledge, in simulation and clinical practice in Otology. Technology is evolving at a rapid rate with new applications being reported at an overwhelming pace. It is important to continuously review new applications, assess emerging trends, and identify challenges to innovation so clinical translation progresses in an efficient and evidenced-based manner. METHODS: A review of 20 years of literature in 3D technology specific to Otology was undertaken using Medline, Embase, PubMed, and Google Scholar search engines. Trends in the literature were analyzed as applications are evaluated and adopted into clinical practice. A literature review was conducted to identify barriers to translation. RESULTS: There was increasing volume of literature reporting innovations in 3D technology in Otology with a more recent increase in reviews and meta-analysis. The most marked trend was in literature regarding clinical applications of such technology and in 3D printing. Where this may indicate that translation of these technologies is adequate, this is not reflected in routine clinical practice or even in education and training platforms. CONCLUSION: Barriers to translation of 3D tools specific to Otology include ongoing challenges in attaining high-resolution data, rendering parameters and with the advent of 3D printing a multitude of new variables in software, printers, and materials adding complexity to selecting most appropriate options. These need methodical evaluation to selectively customize solutions to clinical challenges so effective translation, scale, and adoption can occur without causing confusion about choices.