Third-level Hospital Research Articles

Long COVID in children and adolescents: COVID-19 follow-up results in third-level pediatric hospital.

In children, the manifestations of coronavirus disease 2019 (COVID-19) in the acute phase are considered mild compared with those in adults; however, some children experience a severe disease that requires hospitalization. This study was designed to present the operation and follow-up results of the Post-COVID-19 Detection and Monitoring Sequels Clinic of Hospital Infantil de Mexico Federico Gómez in managing children with a history of SARS-CoV-2 infection. This was a prospective study conducted from July 2020 to December 2021, which included 215 children aged 0-18 years who tested positive for SARS-CoV-2 on polymerase chain reaction and/or immunoglobulin G test. The follow-up was conducted in the pulmonology medical consultation; ambulatory and hospitalized patients were assessed at 2, 4, 6, and 12 months. The median age of the patients was 9.02 years, and neurological, endocrinological, pulmonary, oncological, and cardiological comorbidities were the most commonly observed among the patients. Moreover, 32.6% of the children had persistent symptoms at 2 months, 9.3% at 4 months, and 2.3% at 6 months, including dyspnea, dry cough, fatigue, and runny nose; the main acute complications were severe pneumonia, coagulopathy, nosocomial infections, acute renal injury, cardiac dysfunction, and pulmonary fibrosis. The more representative sequelae were alopecia, radiculopathy, perniosis, psoriasis, anxiety, and depression. This study showed that children experience persistent symptoms, such as dyspnea, dry cough, fatigue, and runny nose, although to a lesser extent than adults, with significant clinical improvement 6 months after the acute infection. These results indicate the importance of monitoring children with COVID-19 through face-to-face consultations or telemedicine, with the objective of offering multidisciplinary and individualized care to preserve the health and quality of life of these children.

How SARS-CoV-2 Infection Impacts the Management of Patients with Vulvar Cancer: Experience in a Third-Level Hospital of Southern Italy

Background: Since February 2020, the spread of Coronavirus Disease 2019 (COVID-19) in Italy has induced the government to call for lockdown of any activity apart from primary needs, and changing the lives of each of us. All that has dramatically impacted the management of patients affected by cancer. Patients with vulvar cancer (VC) represent a particularly frail population because they are elderly and affected by multiple comorbidities. The aim of this study is to evaluate the clinical impact of the SARS-CoV-2 infection on VC patients in terms of delay or impossibility of carrying out the scheduled treatment. Methods: The medical records of patients affected by vulvar tumors, referred to "DAI Materno-Infantile" of AOU Federico II of Naples between February 2020 and January 2022 were retrospectively analyzed. The presence of a positive reverse transcription-polymerase chain reaction (RT-PCR) in nasopharyngeal swab defined the positivity to SARS-CoV-2. Results: Twenty-four patients with VC were analyzed and scheduled for treatment. The median age was 70.7 years (range: 59-80). Seven (29.2%) patients were diagnosed with SARS-CoV-2 infection: In three (42.8%) patients, the treatment was delayed with no apparent consequences, in four (57.2%), the treatment was delayed or changed due to cancer progression and, of these four, one died due to respiratory complications of COVID-19, and one died due to oncologic disease progression. Conclusion: COVID-19 caused, in most cases, significant delays in oncologic treatments and high mortality in our series of patients affected by VC.

Clinical, Laboratory, Cytometry and Cytogenetic Characteristics of a Cohort of Patients Diagnosed with Multiple Myeloma for the First Time in a Third-Level Hospital in Medellín, Colombia, Survival after 8 Years of Follow-Up.

Background: Multiple myeloma is the second most common hematologic malignancy after lymphomas. Few studies have characterized significant and full variables at the time of diagnosis of multiple myeloma in Colombia, and there is no data evaluating patients for follow-up. Materials and Methods: A retrospective cohort study is presented, describing the clinical, laboratory, cytometric, and cytogenetic characteristics of patients with a de novo diagnosis of multiple myeloma evaluated in a reference hematology laboratory attached to a highly complex hospital in Medellín, Colombia. We follow them until death as a main outcome. Results: A total of 170 patients with a de novo diagnosis of multiple myeloma were collected from a database of 421 patients with different monoclonal gammopathies. Mainly, it was found that 50.8% of the patients were men; the median age was 62 years; 65.4% had secretion of the IgG kappa; half of the patients presented International Staging System (ISS) Stage III. The β2 macroglobulin >4 mg/L and creatinine >2 mg/dl were the main variables significantly associated with survival (Hazard Ratio (HR) 2.4 and 2, respectively). Eighty-five percent of patients presented with bone lytic lesion involvement and less than 3% with extramedullary involvement. Conventional Banding Karyotype (CBK) genetic risk assessment yield was poor, compared with although scarce data regarding Cytogenetic risk assessment based on Fluorescence in-situ Hybridization (FISH). Conclusion: The clinical profile of the patients with a de novo diagnosis of multiple myeloma in our cohort is similar to that described in international studies. The diagnosis of multiple myeloma was documented at younger ages, with more advanced stages, anemia, and a high percentage of bone disease. ISS provides an excellent tool for prognosis purposes. Cytogenetic risk assessment based on FISH should be done for all MM patients from therapeutic implications. We need standardized protocols for bone marrow sample manipulation and processing in order to guarantee good correlation for plasma cells count methods.

Strengths and weaknesses of the incident reporting system: An Italian experience

One of the cornerstones for enhancing the patient safety culture is the incident reporting system (IRS). It is a process for detecting, reporting, collecting, and summarizing adverse events (AEs) and near-misses in healthcare, and so it represents a vital tool for clinical risk management. We analyzed the 5-year experience of a third-level hospital's IRSs, showing its trends and highlighting its main strengths and weaknesses. Patients’ falls and physical or verbal aggression toward the providers or between patients are the most reported events. Underreporting is the main limitation of the system, especially among nurses. Visible actions, forceful analysis of the reports, operators’ education, no-blame culture promotion, and organizational adjustments may improve operators’ adherence to IRS. Providers do not willingly inform patients’ relatives about fatal incidents. Despite that, the IRS is far from its potential, and the number of data collected has increased.

Measuring the quantity of light in neonatal care areas in a third-level hospital

Measuring the quantity of light in neonatal care areas in a third-level hospital

QUALITY OF LIFE AFTER CORONAVIRUS DISEASE 2019 HOSPITALIZATION AND REHABILITATION NEEDS.

During the current pandemic, there has been a paucity of Greek data in terms of recording the general long-term functional status of patients after coronavirus disease 2019 (COVID-19) hospitalizations, as well as very little information regarding rehabilitation services nationwide and their utilization. This is a prospective cohort study, including 92 adults discharged from the Infectious Disease Unit of a third-level hospital in Greece after hospitalization with COVID-19. Demographics and disease severity data was collected upon admission and symptoms at discharge, 4 months and 1 year. Following rating of 12 common symptoms on a Likert scale, quality-of-life data and accessibility to rehabilitation services were compared among the 3 time points. At discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. At the 4-month follow-up, only 4.3% of the study participants had visited a rehabilitation facility of any kind, whereas at the 1-year mark the percentage rose to 10.9%. A clinically relevant number of participants experienced at least one post-COVID-19 hospitalization symptom. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. With thousands more being infected and needing hospitalization nationwide daily, the need for the inclusion of relevant rehabilitation programmes in the Greek healthcare system appears imminent.

Mortality and cause of death in patients with dermatologic diseases: An 11-year record-based observational study

Background: Information on the cause of death is critical in guiding decisions on health infrastructure. However, there is a relative paucity of mortality data in patients with dermatologic diseases. Objectives: We aim to assess the overall mortality from dermatological disorders in a third-level university hospital which serves as a dermatology referral center. Methods: A retrospective medical note review of patients with dermatologic diseases who died during an 11-year period (from March 2008 to February 2020) was undertaken. Results: There were 63 death cases out of 2810 admissions for patients with dermatologic diseases (crude mortality 2.24%). The average age was 61.8 years and the male-to-female ratio was 2.3. Cutaneous malignancies (53.96%) were the primary causes of death, followed by drug reactions (23.8%). Among skin cancers, squamous cell carcinoma (SCC; 47.05%) and melanoma (35.29%) were the leading causes of death. Toxic epidermal necrolysis (53.33%) was the leading cause of death among drug reactions. Sepsis (30.74%) was the most common immediate cause of mortality in this series. A large fraction of patients (73%) had significant underlying comorbidities. Conclusion: The principal cause of mortality was cutaneous malignancies (mainly SCC and melanoma) followed by drug reactions. Sepsis was the most common immediate cause of death.

Evaluation of the characteristics of the patients Hospitalized in the internal diseases clinic in a third-level hospital a single-center experience

Objective: General internal medicine clinics are units where patients are evaluated holistically and systematically by working together with other branches of specialization. In the present study, the purpose was to reveal the general internal medicine practice by examining the characteristics and reasons for the hospitalization of patients in the general internal medicine clinic of a third-level university hospital. Material and Methods: The data of patients who were hospitalized between 01.10.2020 and 01.10.2022 in Afyonkarahisar Health Sciences University, Faculty of Medicine, Internal Medicine Clinic, General Internal Medicine Ward were obtained. The demographic data, reasons for hospitalization, and hospitalization areas of the patients were examined. Results: A total of 714 patients were included in the present study. The mean age of the patients was 59.9. The most common reason for hospitalization was symptomatic anemia and malignancy screening. Although symptomatic anemia was the most common reason for hospitalization over 65 years of age, intoxications were observed in patients under 65 years of age and the most common reason for hospitalization from the emergency units was acute pancreatitis, the most common reason for hospitalization from clinics was malignancy examination. Conclusion: General internal medicine clinics have a wide spectrum in terms of hospitalization causes. The most common reasons for admission to these units are anemia, malignancy examination, and electrolyte disorders.

918. Influence of a hospital-based antimicrobial stewardship program on clinical and economic outcomes. The experience from a referral center in Mexico.

Abstract Background Antibiotic stewardship programs (ASP) are relatively new in Mexico. It was until May 2018 that it was established as a public health policy in the country. Few hospitals have acknowledged the mandate and started an ASP despite the efforts. Besides, little has been done to evaluate the efficacy of the program in terms of antibiotic expenditure and the incidence of associated infections. Therefore, the main objective was to evaluate antibiotic expenditure before and after the ASP in a third-level hospital in Mexico. As a secondary analysis, the relationship with Clostridioides difficile infections was explored. Methods This is a retrospective and descriptive study from January 2017 to February 2020 (pre-COVID-19 pandemic). First, the mean antibiotic expenditure (adjusting for DDD/patient days-costs in USD) was evaluated before and after (June 2018 as the first month of implementation) the ASP. Statistical difference of the means was evaluated. It was also performed an exploratory analysis between the prescription of Clindamycin and Levofloxacin with the number of cases and deaths related to C. difficile infection. Results The average antibiotic expenditure before ASP was US$13,468 ± 3,267, and US$8,193 ± 2,574 (p< 0.001) after. Graph 1 presents the changes in trend. Specifically, caspofungin, ciprofloxacin, clindamycin, fluconazole, levofloxacin, linezolid, piperacillin/tazobactam, and tigecycline showed statistically significant reduction after June 2018. Graph 2 displays the descriptive relationship between the prescription of levofloxacin and clindamycin, the cases of C. difficile infection, and the elimination of all associated mortality. Graph 1. Antibiotic expenditure. Before and after AMS Graph 2. Relationship between monthly consumption of clindamycin and levofloxacin and the number of cases/deaths secondary to Clostridioides difficile infections, before and after ASP. Conclusion The ASP has significantly reduced the antibiotic expenditure in the hospital. Besides reducing the prescription of associated antibiotics, a possible reduction in C. difficile infections and associated deaths were observed. Disclosures All Authors: No reported disclosures.

S111 In Search of Deep Remission in Ulcerative Colitis: Our Experience in a Third-Level Hospital in Mexico

S111 In Search of Deep Remission in Ulcerative Colitis: Our Experience in a Third-Level Hospital in Mexico

Efficacy and safety of treatment with terlipressin infusion vs. bolus in gastrointestinal bleeding of variceal origin in a third-level hospital

Efficacy and safety of treatment with terlipressin infusion vs. bolus in gastrointestinal bleeding of variceal origin in a third-level hospital

EFFICACY OF CANNABIDIOL IN DRUG RESISTANT EPILEPSY IN A PRIVATE THIRD-LEVEL HOSPITAL

Introduction: In 2016, the rst results of phase III clinical trials showed benecial effects of CBD in treatment-resistant seizure disorders, Objective: To evaluate the efcacy of cannabidiol in patients with drug resistant epilepsy in a private third-level hospital. Methods: Descriptive, retrospective, observational and cross-sectional study. Inclusion criteria were patients under treatment with cannabidiol and drug resistant epilepsy from January 2017 to March 2022. Study variables were age, gender, evolution of epilepsy (years), epileptic syndromes, numbers of antiseizure drugs, reduction of seizures (more tan 50%), cannabidiol dose (mg/kg/day), treatment time (months) and adverse effects. Information was captured in Excel and analyzed in SPSS. Results: 31 patients. The epileptic syndromes found were Lennox Gastaut 32%, West 12.9%, Dravet 3.2%, Doose 3.2% and no syndromic 48.3%. Reduction of seizures more than 50% was shown in 25 patients (80.6%). Seizure free in 5 patients (16%). Cannabidiol dose was: <1 mg/kg/day (9.6%), 1-5 mg/kg/day (77.4%), >5 mg/kg/day (12.9%). Association was found between a decrease in the number of seizures and a higher dose of cannabidiol with statistical signicance (p<0.05). Conclusion: Our study suggests that cannabidiol reduces seizures with few adverse effects in drug resistant epilepsy

Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19).

Background: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SARS-CoV-2-positive patients being hospitalized in a non-ICU setting. Aim and Methods: We have carried out a retrospective study to evaluate frequency and risk factors for AKI among patients consecutively admitted at a third-level university hospital starting from February 2020 (the beginning of the first wave of the SARS-CoV-2 pandemic); all patients were hospitalized outside the ICU. Results: A total of 387 SARS-CoV-2-positive patients were included in the current study; 372 (96.1%) had SARS-CoV-2-related pneumonia. In-hospital AKI onset was recorded in 119 (30.7%) patients, mainly with AKI stage 1 (n = 74, 62.2%); eighteen (4.6%) patients reported AKI stage 3 and six (1.5%) patients had HD-dependent AKI. There were 235 (60.7%) patients with severe COVID-19, and this was more common in patients developing AKI, 94.5% (86/119) vs. 86.1% (149/268), p = 0.02. Multivariate regression model (n = 144 patients) reported an independent and significant relationship between AKI occurrence and greater levels of ferritin (p = 0.036), IL-6 (p = 0.032), and azotemia at admission (p = 0.0001). A total of 69 (17.8%) SARS-CoV-2-positive patients died and strong predictors of in-hospital death resulted from age (p < 0.0001), serum ferritin (p < 0.0001) and white blood cells (p < 0.001). According to multivariable analysis (n = 163 patients), there was a consistent link between in-hospital death and AKI stage (1) (p = 0.021) and -stage (2) (p = 0.009). Our results support the notion that AKI occurs frequently among hospitalized COVID-19 patients even in a non-ICU setting and plays a pivotal role in the mortality of this population. Further studies are ongoing in order to clearly establish the frequency of AKI in patients with COVID-19; the mechanisms underlying kidney injury in this population are an area of active investigation. These data provide solid evidence to support close monitoring of COVID-19 patients for the development of AKI and measures taken to prevent this.

The effect of the SARS-CoV-2 pandemic in the compliance of hand hygiene in ICU in a tertiary hospital

Abstract Background Hand hygiene (HH) is one of the main preventive methods for healthcare-associated infections. Our aim is to compare the level of HH compliance in 2021, SARS-CoV-2 pandemic period, with the previous 2019 period. Methods Descriptive cross-sectional study of direct observation on compliance of HH in adult intensive care unit (AICU) and neonatal intensive care unit (NICU) in a third-level hospital in Madrid during the years 2019 and 2021. Trained healthcare workers observed and recorded hand hygiene opportunities (HHO) among staff (nurse, nurses’ aide, physicians and orderly) using the World Health Organization's “My Five Moments for Hand Hygiene” tool. All observations of professional that attended patients in SARS-CoV-2 isolation units were excluded. Results Overall, there was a total of 1199 HHO, 961 in AICU (2019:466; 2021:495) and 238 in NICU (2019:122; 2021:116). HH compliance in AICU improved from 57.5% in 2019 to 65.9% in 2021 (p = 0.008) and remained unchanged in NICU (2019:90.2% vs 2021:88.8%; p = 0.730). In AICU all professional categories, except nurse’s aide, improved HH compliance being statistically significant in physicians (2019:33.8% vs 2021:50.0%; p = 0.009). In relation to the 5 moments, an increase in HH compliance was observed in: before and after touching a patient/after touching patient surroundings, being only statistically significant in moment after touching a patient (2019:69.4% vs 2021:83.7%; p = 0.001). In NICU there were no significant changes between the two periods regarding to the professional category or the five moments of HH. In NICU there were no significant changes between the two periods regarding to the professional category or the five moments of HH. Conclusions The increase in compliance of HH within the adult ICUs demonstrates this adaptation, stating a behavioural change in the habits of professionals. This increase was no observed in the NICU since their compliance was already extremely high. Key messages • There has been an increase in HH compliance in the AICU. • The HH method has varied, becoming COVID-19 specific.

An explanatory model of depressive symptoms from anxiety, post-traumatic stress, somatic symptoms, and symptom perception: the potential role of inflammatory markers in hospitalized COVID-19 patients

BackgroundThe context of the COVID-19 pandemic has harmed the mental health of the population, increasing the incidence of mental health problems such as depression, especially in those who have had COVID-19. Our study puts forward an explanatory model of depressive symptoms based on subjective psychological factors in those hospitalized for COVID-19 with and without biological markers (i.e., inflammatory markers). Therefore, we aim to evaluate the hypotheses proposed in the model to predict the presence of depressive symptoms.MethodWe conducted a cross-sectional study, using a simple random sampling. Data from 277 hospitalized patients with COVID-19 in Lima-Peru, were collected to assess mental health variables (i.e., depressive, anxiety, post-traumatic stress, and somatic symptoms), self-perception of COVID-19 related symptoms, and neutrophil/lymphocyte ratio (NLR) such as inflammatory marker. We performed a structural equation modeling analysis to evaluate a predictive model of depressive symptoms.ResultsThe results showed a prevalence of depressive symptoms (11.2%), anxiety symptoms (7.9%), somatic symptoms (2.2%), and symptoms of post-traumatic stress (6.1%) in the overall sample. No association was found between the prevalence of these mental health problems among individuals with and without severe inflammatory response. The mental health indicators with the highest prevalence were sleep problems (48%), low energy (47.7%), nervousness (48.77%), worry (47.7%), irritability (43.7%) and back pain (52%) in the overall sample. The model proposed to explain depressive symptoms was able to explain more than 83.7% of the variance and presented good goodness-of-fit indices. Also, a different performance between the proposed model was found between those with and without severe inflammatory response. This difference was mainly found in the relationship between anxiety and post-traumatic stress symptoms, and between the perception of COVID-19 related symptoms and somatic symptoms.ConclusionsResults demonstrated that our model of mental health variables may explain depressive symptoms in hospitalized patients of COVID-19 from a third-level hospital in Peru. In the model, perception of symptoms influences somatic symptoms, which impact both anxiety symptoms and symptoms of post-traumatic stress. Thus, anxiety symptoms could directly influence depressive symptoms or through symptoms of post-traumatic stress. Our findings could be useful to decision-makers for the prevention of depression, used to inform the creation of screening tools (i.e., perception of symptoms, somatic and anxiety symptoms) to identify vulnerable patients to depression.

Survival analysis and identification of prognostic factors in colorectal liver metastasis after liver resection

IntroductionLiver resection is the only curative treatment for colorectal liver metastasis. The identification of predictive factors leads to personalize patient management to enhance their long-term outcomes. This population-based study aimed to characterize factors associated with, and survival impact of patients who received hepatectomy for colorectal liver metastasis. MethodsA retrospective cohort study of all the hepatectomies for colorectal liver metastasis performed at third-level hospital of Spain (2010–2018) was conducted. The Kaplan–Meier method was used for survival analyses. Multivariable Cox and regression models were used to determine prognostic factors associated with overall survival. ResultsThe 5-year overall survival and disease-free survival were 42 and 33%, respectively. Survival analysis showed that metastasis features (number, largest size, distribution, and extrahepatic disease) and postsurgical factors (transfusion, major complications, and positive margin resection), as well as non-mutated KRAS, showed a significant association with survival. Otherwise, on multivariate analysis, only 5 independent risk factors were identified: major size metastasis >4 cm, RAS mutation, positive margin resection, intraoperative transfusion, and major complications. ConclusionsAccording to our findings, major size metastasis >4 cm, intraoperative transfusion, and major postoperative complications continue to be traditional prognostic factors. Meanwhile, the KRAS biomarker has a powerful impact as a survival prognostic factor.

Impact and characteristics of hospital-acquired influenza over 10 seasons in a third-level university hospital

ObjectivesTo analyze the characteristics of patients with nosocomial flu, to compare them with patients with community-acquired influenza to study possible differences and to identify possible risk factors associated with this type of flu. Patients and methodsObservational, cross-sectional and retrospective study of hospitalized patients with a microbiological confirmation of influenza in a third-level university hospital over 10 seasons, from 2009 to 2019. Nosocomial influenza was defined as that infection whose symptoms began 72h after hospital admission, and its incidence, characteristics and consequences were further analyzed. ResultsA total of 1260 hospitalized patients with a microbiological diagnosis of influenza were included, which 110 (8.7%) were nosocomial. Patients with hospital-acquired influenza were younger (71.74±16.03 years, P=0.044), had a longer hospital stay (24.25±20.25 days, P<0.001), had more frequently a history of chronic pulmonary pathologies (P=0.010), immunodeficiency (P<0.001), and were associated with greater development of bacterial superinfection (P<0.001), respiratory distress (P=0.003), and admission to the intensive care unit (ICU) (P<0.001). In the multivariate logistic regression analysis, the following characteristics were identified as independent risk factors: immunodeficiency (ORa=2.33; 95% CI: 1.47–3.60); ICU admission (ORa=4.29; 95% CI: 2.23–10.91); bacterial superinfection (ORa=1.64; 95% CI: 1.06–2.53) and respiratory distress (ORa=3.88; 95% CI: 1.23–12.23). ConclusionsNosocomial influenza is more common in patients with a history of immunodeficiency. In addition, patients with hospital-acquired influenza had an increased risk of bacterial superinfection, admission to the ICU, and development of respiratory distress.

Üçüncü Basamak Acil Servis Başvurularının Resmî Tatil Günlerine Göre Dağılımının Değerlendirilmesi

Objective: It is aimed to examine the numerical change in the emergency department patient admissions of a third-level hospital on public holidays and to offer solutions to the overcrowding in the emergency department with these data.Material and Methods: The records of patients who were admitted to the emergency department between 01.01.2015 and 31.12.2018 were analyzed retrospectively. The age, gender, admission date data of the patients during the study period were recorded and compared by determining the official holidays and other working days.Results: During the specified date range, 543,138 patient admissions were made, and 52% of them were men. The mean age of the patients was 41 years. August (10.2%) was the month with the highest number of patient admissions; Monday (15.5%) was the day with the highest number of patient admissions. It was observed that the admissions were mostly in the 12:00-18:00 time zone (33.6%). In the emergency department, where the average number of patients per day was 366, an average of 503 patients admissions were made on public holidays on weekdays (p&amp;lt;0.001).Conclusion: Emergency department patient density exhibits temporal differences. Emergency department applications show a significant increase during public holidays that coincide with weekdays.

Prevalence of meningitis in newborns with fever in a third-level hospital center: Meningitis in febrile newborns

Prevalence of meningitis in newborns with fever in a third-level hospital center: Meningitis in febrile newborns

Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients

Background and objectiveMinimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarise its key points through a case series. Materials and methodsRetrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry. ResultsSix patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (±21.9). Four tumours were in the left ear and 2 in the right ear. These included four tympanic paragangliomas (three type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months. ConclusionsThe present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity.