Traditional Microscopy Techniques Research Articles

Health-related quality of life in patients after endoscopic or microscopic cholesteatoma surgery.

Different surgical techniques exist for treating cholesteatoma, such as microscopical or transcanal endoscopic ear surgery (TEES). This study aimed to compare these two techniques, focusing on quality of life. This retrospective single-center study included 188 patients with cholesteatoma. The primary outcome was the assessment of health-related quality of life (HRQoL) using the Zurich Chronic Middle Ear Inventory (ZCMEI-21) preoperatively, 3 and 12 months postoperatively with regard to surgical technique and intraoperative staging of the cholesteatoma (ChOLE classification). Secondary outcomes included hearing pure tone average of 0.5, 1, 2 and 4kHz (PTA4), complications assessed 3 months postoperatively as well as recidivism within the follow-up time of 1 year postoperatively. A total of 28 patients underwent TEES and 160 microscopic ear surgery. The ZCMEI-21 total scores preoperatively were not significantly different between the two groups. An improvement in QoL one year postoperatively was observed in both groups to a comparable extent. The ZCMEI-21 decreased significantly (p <0.01) in both groups. In the TEES group, the cholesteatoma tended to be smaller (lower ChOLE score), PTA4 was better and complication rate comparable. The number of recidivisms was lower for the TEES group (1 [3.6%] vs. 31 [19.4%]). TEES is a valuable alternative to the traditional microscopic technique, at least for small cholesteatoma, which leads to a comparable improvement in HRQoL as the microscopic technique. The better postoperative hearing and lower rate of recidivism in the TEES group may be related to the smaller extent of the cholesteatoma.

Spectral Pyrometry for Practical Temperature Measurement in the TEM.

Recent work in ultra-high temperature in situ electron microscopy has presented the need for accurate, contact-free temperature determination at the microscale. Optical measurement based on thermal radiation (pyrometry) is an attractive solution but can be difficult to perform correctly due to effects, such as emissivity and optical transmission, that must be accounted for. Here, we present a practical guide to calibrating and using a spectral pyrometry system, including example code, using a Czerny-Turner spectrometer attached to a transmission electron microscope. Calibration can be accomplished using a thermocouple or commercial heated sample holder, after which arbitrary samples can be reliably measured for temperatures above ∼600∘C. An accuracy of 2% can be expected with the possibility of sub-second temporal resolution and sub-Kelvin temperature resolution. We then demonstrate this capability in conjunction with traditional microscopic techniques, such as diffraction-based strain measurement for thermal expansion coefficient, or live-video sintering evolution.

Exclusive endoscopic tympanoplasty efficacy in the treatment of cholesteatoma without mastoid involvement.

The purpose of this study is to determine the recurrence rate of cholesteatoma in patients who have undergone exclusive endoscopic tympanoplasty at our tertiary referral institution. A secondary objective is to analyze different clinical aspects that could be considered risk factors for recurrence to establish if it is possible to determine when a second-look procedure is indicated instead of a clinical follow-up. A retrospective study was performed on patients who had undergone exclusive endoscopic tympanoplasty for cholesteatoma in the last eight years and who were followed up for at least one year. The efficacy of the treatment performed only with the exclusive endoscopic technique was analyzed. Then, the anamnestic and intraoperative data were studied to identify possible factors that could increase the risk of recurrence. The recurrence rate (14.5%) in patients (164) who underwent primary surgery with the exclusive endoscopic technique between January 2014 and January 2022 was similar to that in patients who underwent the microscopic technique with mastoidectomy in literature. In addition, we analyzed several clinical factors such as age, ossicular chain erosion, extension and localization of the cholesteatoma finding that only the last one could potentially be a risk factor for recurrence in this selected population. Exclusive endoscopic tympanoplasty has been shown to be effective in removing cholesteatoma in patients without evidence of mastoid involvement, with recurrence rates comparable to traditional microscopic technique and a minimally invasive approach, even considering the patient's age, ossicular chain erosion and extension of the disease.

New Frontiers in Pediatric Cochlear Implant Surgery - A Single Center Experience with the 3-Dimensional Exoscope.

Since its introduction by Wullstein, the binocular surgical microscope has remained the gold standard of visualization in the field of otology. However, in the last decade, new technology became available in the form of the three-dimensional (3D) exoscope. In this article, we describe our experience thus far in pediatric cochlear implantation with the 3D exoscope. This article is about prospective descriptive study of all exoscopic cochlear implant (CI) cases in a quaternary pediatric CI center performed with the Vitom® 3D system. All pediatric patients (age <18) were included without exclusion criteria, and our experience and conversion to microscope rates are reported. Since the introduction of the exoscope to our unit, we have successfully performed 68 cases, of which 53 were bilateral cochlear implantations. The age of the patient varied between 10 months and 209 months (average: 64 months; median 46.5 months). There were a total of 121 implantations (96 primary implantations, 24 revision implantations). There were 2 conversions to the traditional microscopic technique. The exoscope provides a 3D high-definition (4K) images in CI surgery. There is limited data regarding its use, and we identified a number of advantages including efficiency, occupational health, theater utilization, surgical training, and safety. Although there are areas still for improvement, such as loss of signal-to-noise ratio at higher magnification, manual focus, and lack of electromagnetic articulation in the holding arm, we have found it to be a useful addition to the surgical armamentarium within pediatric cochlear implantation.

The benthic and epiphytic marine dinoflagellates of Aotearoa New Zealand and Rangitāhua Kermadec Islands, an updated checklist from 2018 to 2024

ABSTRACT A checklist collating records of New Zealand’s benthic and epiphytic dinoflagellate species was published on-line in 2018 [Rhodes L, Smith KF. 2019. A checklist of the benthic and epiphytic marine dinoflagellates of New Zealand, including Rangitāhua/Kermadec Islands. N Z J Mar Freshw Res. 53:258–277. doi:10.1080/00288330.2018.1492425]. Over the last six years, seventeen species from nine genera (three newly reported genera) have been documented, including sand-dwelling species. Isolation and identification of species using traditional microscopic techniques combined with analysis of DNA sequencing data has been supplemented by high-throughput sequencing techniques (i.e. metabarcoding). Toxin data, based on liquid chromatography mass spectrometry (LC-MS/MS), and toxicity of isolates are included where applicable. Forty-two benthic and epiphytic dinoflagellate genera, including genera having benthic life stages, have now been recorded in Aotearoa New Zealand coastal waters including Rangitāhua Kermadec Islands (new record genera in bold): Adenoides , Alexandrium, Amphidinium, Archaeperidinium, Azadinium, Biecheleria, Blastodinium, Bysmatrum, Cachonina, Coolia, Crypthecodinium, Cryptoperidiniopsis, Dinophysis, Durinskia, Ensiculifera, Fukuyoa, Fragilidium, Gambierdiscus, Gonyaulax, Gymnodinium, Gyrodinium, Heterocapsa, Karenia, Karlodinium, Kryptoperidinium, Lepidodinium, Ostreopsis, Pelagodinium, Pentapharsodinium, Pfiesteria, Polarella, Prorocentrum, Protodinium, Protoperidinium, Pseudadenoides , Pseudopfiesteria, Scrippsiella, Symbiodinium, Thecadinium , Togula, Vulcanodinium and Woloszynskia.

Patient satisfaction with endoscopic ear surgery technique: a comparative study with the postauricular incision microscopic technique

BackgroundEndoscopic ear surgery has numerous benefits, such as the capacity to obtain high-resolution pictures and visualize normally inaccessible locations such as the retrotympanum, sinus tympani, and facial recess. These areas are generally difficult to access with traditional microscopic techniques. Endoscopic ear surgery reduces operating time when performed by skilled surgeons, without the need for a postauricular incision wound.An essential aspect to consider when evaluating the effects of any procedure on individual satisfaction is the assessment of health-associated quality of life. It is a tool used for subjective assessment, which is regarded as a reliable measure of the satisfaction perceived—whether physically or mentally—resulting from a certain procedure.The goal of this study was to identify the benefits of middle ear surgery when done endoscopically compared to postauricular microscopic techniques in middle ear surgery. This was achieved by evaluating and comparing the level of satisfaction among patients who underwent either microscopic or endoscopic ear surgery.MethodsThe Chronic Ear Surgery Survey (CESS), a 13-point Likert scale survey designed specifically for assessing outcomes of surgery for chronic middle ear disease, was implemented to measure patient satisfaction. The survey comprises three subscales. We performed a retrospective study at the Otorhinolaryngology Department, Cairo University, Egypt. The study encompassed individuals who underwent surgery on the middle ear between March 2018 and September 2021.The patients were scheduled into two categories according to the technique of surgery (whether endoscopic or microscopic) in order to assess postoperative satisfaction using the Chronic Ear Surgery Survey (CESS).ResultsOur research findings demonstrated a statistically significant difference between the two categories in terms of the overall scores and all subscale scores of the Chronic Ear Surgery Survey (CESS), with patients who had middle ear surgery endoscopically (EES) showing better outcomes.ConclusionsIdentifying the elements that are strongly associated with subjective outcomes can assist surgeons in identifying patients who are more likely to have poorer satisfaction. This knowledge can be valuable in preoperative counseling. Endoscopic ear surgery (EES) seems to have a higher level of cosmetic acceptability, especially in terms of enhancing the socially related aspects of a patient's pleasure. This work thus supports the ongoing integration of endoscope utilization in otological surgical procedures.

Deep-ultraviolet Fourier ptychography (DUV-FP) for label-free biochemical imaging via feature-domain optimization

We present deep-ultraviolet Fourier ptychography (DUV-FP) for high-resolution chemical imaging of biological specimens in their native state without exogenous stains. This approach uses a customized 265-nm DUV LED array for angle-varied illumination, leveraging the unique DUV absorption properties of biomolecules at this wavelength region. We implemented a robust feature-domain optimization framework to overcome common challenges in Fourier ptychographic reconstruction, including vignetting, pupil aberrations, stray light problems, intensity variations, and other systematic errors. By using a 0.12 numerical aperture low-resolution objective lens, our DUV-FP prototype can resolve the 345-nm linewidth on a resolution target, demonstrating at least a four-fold resolution gain compared to the captured raw images. Testing on various biospecimens demonstrates that DUV-FP significantly enhances absorption-based chemical contrast and reveals detailed structural and molecular information. To further address the limitations of conventional FP in quantitative phase imaging, we developed a spatially coded DUV-FP system. This platform enables true quantitative phase imaging of biospecimens with DUV light, overcoming the non-uniform phase response inherent in traditional microscopy techniques. The demonstrated advancements in high-resolution, label-free chemical imaging may accelerate developments in digital pathology, potentially enabling rapid, on-site analysis of biopsy samples in clinical settings.

Contemporary Methodologies for Identifying and Categorizing Microalgae: A Comprehensive Review and Future Perspectives

As more people become connected to the grid and the energy demand continues to increase, non-renewable energy sources are being consumed at a faster rate than they are being replaced. Microalgae, often referred to as "green gold" have shown great potential as a renewable energy source due to their unique characteristics. However, not all microalgae are suitable to use as replacements for traditional fossil fuels. Therefore, it is essential for researchers to accurately identify and classify microalgae based on their species and energy-producing capabilities. The main objective of this paper is to present a detailed summary of the current technologies employed in the classification and detection of microalgae. Both traditional manual microscopy and advanced artificial intelligence techniques such as machine learning and deep learning are covered in this overview. Furthermore, this paper offers a critical analysis of these technologies and provides suggestions for enhancing their effectiveness. Despite deep learning being the most advanced technology for microalgae classification and detection, there is still significant potential for future improvements that could further increase the accuracy.

Enhancing early warning: A DNA biosensor with polyaniline/graphene nanocomposite for label-free voltammetric detection of saxitoxin-producing harmful algae

Yearly reports of detrimental effects resulting from harmful algal blooms (HAB) are still received in Malaysia and other countries, particularly concerning fish mortality and seafood contamination, both of which bear consequences for the fisheries industry. The underlying reason is the absence of a dependable early warning system. Hence, this research aims to develop a single DNA biosensor that can detect a group of HAB species known for producing saxitoxin (SXT), which is commonly found in Malaysian waters. The screen-printed carbon electrode (SPCE)-based DNA biosensor was fabricated by covalent grafting of the 3’ aminated DNA probe of the sxtA4 conserved domain in SXT-producing dinoflagellates on the reverse-phase polymerized polyaniline/graphene (PGN) nanocomposite electrode via carbodiimide linkage. The introduction of a carboxyphenyl layer to the PGN nanotransducing element was essential to augment the carboxylic groups on the graphene (RGO), facilitating attachment with the aminated DNA. The synergistic effect of the asynthesized nanocomposite of PANI and RGO, tremendously enhanced the electron transfer rate of the ferri/ferrocyanide redox probe at the SPCE transducer surface, allowing for the label-free bioanalytical assay of complementary DNA targets. The developed DNA biosensor featuring the capacity to detect a broad range of Alexandrium minutum (A. minutum) cell concentrations, ranging from 10 to 10,000,000 cells L-1. The quantification of A. minutum cells from pure algal culture by the electrochemical DNA biosensor has been well-validated with traditional microscopic techniques. Furthermore, Alexandrium tamiyavanichii, another toxigenic HAB species, exhibited a similar electrochemical characteristic signal to those observed with A. minutum, whilst the biosensor yielded appreciably distinctive results when subjected to a non-toxigenic microalgae species as a negative control, i.e. Isochrysis galbana. A compendium DNA biosensor design and electrochemical detection strategy at laboratory scale serves as a precursor to the potential development of portable device for on-site detection, thus expanding the utility and scope of biosensor technology.

Flow-through imaging and automated analysis of oil-exposed early stage Atlantic cod (Gadus morhua)

Toxicology studies in early fish life stages serve an important function in measuring the impact of potentially harmful substances, such as crude oil, on marine life. Morphometric analysis of larvae can reveal the effects of such substances in retarding growth and development. These studies are labor intensive and time consuming, typically resulting in only a small number of samples being considered. An automated system for imaging and measurement of experimental animals, using flow-through imaging and an artificial neural network to allow faster sampling of more individuals, has been described previously and used in toxicity experiments. This study compares the performance of the automated imaging and analysis system with traditional microscopy techniques in measuring biologically relevant endpoints using two oil treatments as positive controls. We demonstrate that while the automated system typically underestimates morphometric measurements relative to analysis of manual microscopy images, it shows similar statistical results to the manual method when comparing treatments across most endpoints. It allows for many more individual specimens to be sampled in a shorter time period, reducing labor requirements and improving statistical power in such studies, and is noninvasive allowing for repeated sampling of the same population.

The Role of Microscopic Disease Analysis in Diagnosing Infectious Diseases

Microscopic disease analysis stands as a pivotal technique in the realm of infectious disease diagnosis. Tracing back to the 17th century, the advent of microscopy introduced an unprecedented method of directly observing pathogens, profoundly transforming both our comprehension and diagnostic approach to infectious diseases. Principal microscopic techniques have come to the fore, including: light microscopy, invaluable for identifying parasites such as Plasmodium; electron microscopy, delivering superior magnification and resolution suitable for visualizing minuscule pathogens like viruses; and fluorescence microscopy, utilizing fluorescence dyes to differentiate pathogens based on their emitted light. These techniques collectively present a unique diagnostic trifecta: rapid results delivery, cost-effectiveness, and high specificity. However, they aren't without challenges. Reliable results demand meticulous sample preparation and are substantially operator-dependent. Also, there are inherent constraints related to magnification and resolution, particularly with light microscopy. While the medical field witnesses the rise of advanced molecular diagnostic methods, the relevance of microscopy remains undiminished. The future of infectious disease diagnosis appears promising, especially with the anticipated fusion of traditional microscopic techniques with innovative technological advancements, aiming for greater diagnostic precision and efficiency.

Hybrid machine-learning framework for volumetric segmentation and quantification of vacuoles in individual yeast cells using holotomography.

The precise, quantitative evaluation of intracellular organelles in three-dimensional (3D) imaging data poses a significant challenge due to the inherent constraints of traditional microscopy techniques, the requirements of the use of exogenous labeling agents, and existing computational methods. To counter these challenges, we present a hybrid machine-learning framework exploiting correlative imaging of 3D quantitative phase imaging with 3D fluorescence imaging of labeled cells. The algorithm, which synergistically integrates a random-forest classifier with a deep neural network, is trained using the correlative imaging data set, and the trained network is then applied to 3D quantitative phase imaging of cell data. We applied this method to live budding yeast cells. The results revealed precise segmentation of vacuoles inside individual yeast cells, and also provided quantitative evaluations of biophysical parameters, including volumes, concentration, and dry masses of automatically segmented vacuoles.

83 Assessing Exposure to Fungal Bioaerosols in Transport Environments: Analysing Fungal Composition of Passive Dust Samples Collected in UK Railway Stations

Abstract Bioaerosols consist of a complex mixture of airborne microorganisms including fungi, bacteria, pollen, particulates and by-products of cells. While exposure to diverse microorganisms is essential for normal immune system development, bioaerosol inhalation has been associated with respiratory allergy and inflammation. Bioaerosols are ubiquitous, yet their composition within different environments is not well understood. Such information is essential for assessing exposure and associated health impacts. Here we focus on transport environments, namely railway stations (RSs), which pose a potential source of occupational and community exposure. Over 1200 passive dust samples were taken from 17 RSs across the UK from 03/2014-05/2015. Geographical Information System methods were used to provide information on population characteristics of the immediate surrounding area of the RSs. Together with information on RS layout and passenger numbers, this informed the selection of 250 samples, representing 9 RSs of varied geographical location, layout and footfall for further analysis. High throughput sequencing (HTS) with a metabarcoding approach targeting the ITS2 region was used to analyse the fungal composition of the sample subset. Such HTS techniques provide an opportunity to measure a wider range of microorganisms than traditional culture or microscopy techniques. RS characteristics were varied and included indoor/enclosed and mostly outdoor layouts. Annual footfall varied from approximately 10-148 million. The fungal composition of RS over time and relationships with different RS characteristics will be presented, identifying those driving any differences in composition.

Automated detection and growth tracking of 3D bio-printed organoid clusters using optical coherence tomography with deep convolutional neural networks.

Organoids are advancing the development of accurate prediction of drug efficacy and toxicity in vitro. These advancements are attributed to the ability of organoids to recapitulate key structural and functional features of organs and parent tumor. Specifically, organoids are self-organized assembly with a multi-scale structure of 30-800μm, which exacerbates the difficulty of non-destructive three-dimensional (3D) imaging, tracking and classification analysis for organoid clusters by traditional microscopy techniques. Here, we devise a 3D imaging, segmentation and analysis method based on Optical coherence tomography (OCT) technology and deep convolutional neural networks (CNNs) for printed organoid clusters (Organoid Printing and optical coherence tomography-based analysis, OPO). The results demonstrate that the organoid scale influences the segmentation effect of the neural network. The multi-scale information-guided optimized EGO-Net we designed achieves the best results, especially showing better recognition workout for the biologically significant organoid with diameter ≥50μm than other neural networks. Moreover, OPO achieves to reconstruct the multiscale structure of organoid clusters within printed microbeads and calibrate the printing errors by segmenting the printed microbeads edges. Overall, the classification, tracking and quantitative analysis based on image reveal that the growth process of organoid undergoes morphological changes such as volume growth, cavity creation and fusion, and quantitative calculation of the volume demonstrates that the growth rate of organoid is associated with the initial scale. The new method we proposed enable the study of growth, structural evolution and heterogeneity for the organoid cluster, which is valuable for drug screening and tumor drug sensitivity detection based on organoids.

Confocal Raman microscopy to evaluate anisotropic structures and hydration development. Methodological considerations.

Confocal Raman microscopy is a promising technique to study structural complexity of multi-phase foods and soft materials. This technique overcomes the limitations of traditional microscopic techniques, such as the inability to identify water regions or to map the composition of various phases in situ, without sample disruption or the addition of specific dyes. The objective of this work was to carry out a systematic study on a well-understood model food, pizza cheese, establishing a methodology for data acquisition and handling for confocal Raman microscopy studies of anisotropic protein structures. The study demonstrated that conventional confocal microscopy remains an important tool to study the structure of protein networks. However, confocal Raman microscopy brings added value in the observation of components distribution, for example, water distribution in the protein phase during storage, using line scans or area imaging, and to detect spatial heterogeneities. This research compared different means of processing spectroscopic data, and demonstrates the critical importance of data handling, advocating for detailed methodological descriptions to better compare research results.

Role of anti-Giardia recombinant cyst wall protein IgG polyclonal antibodies in diagnosis and protection

Giardia duodenalis (G. duodenalis) is an infectious protozoan that has a global distribution especially in the hot climate. Around 200 million people are infected worldwide annually by Giardia, but infection is not always accompanied by symptoms, especially in endemic countries. Using traditional microscopy techniques in diagnosis, both in stool and water samples were less sensitive when compared to immunological methods; and the need for new diagnostic methods was necessary. Also, protection from infection is required in endemic areas. Therefore, the study aimed to produce anti- G. duodenalis IgG polyclonal antibodies (pAbs) by immunizing rabbit by G. duodenalis cyst recombinant protein. The produced antibodies were evaluated in the detection of G. duodenalis antigens in patients’ stool and water samples from endemic areas across River Nile; where pAbs were used as a coating and a peroxidase conjugate antibody in sandwich ELISA. Moreover, pAbs were tested for the protection of mice from giardiasis. Sandwich ELISA using pAb has succeeded in the detection of G. duodenalis coproantigens in stool samples by a sensitivity of 97% and a specificity of 92.72%. Moreover, G. duodenalis cyst was detected in only seven water samples by ordinary microscopy; while sandwich ELISA revealed nineteen positive results. IgG pAb (1/200 µg/ml) protected mice from giardiasis; which was evident from the reduction in cysts and trophozoites numbers. We recommended the use of sandwich ELISA to monitor water quality, investigate environmental contamination and diagnosis in patients' stools. The pAbs can be prepared in large amount and used in field diagnosis and protection. This will help in the early diagnosis of G. duodenalis in water, which in turn can control outbreaks in rural areas.

Application of deuterium oxide (D2O) isotope tracing technique for encapsulated QFN failure analysis

Polymer encapsulated components are universally used in consumable applications. However, polymer encapsulants for packages commonly are non-hermetic. The polymer encapsulants can absorb moisture from atmosphere which will post a risk to the package reliability. In this study, a type of polymer encapsulated Quad Flat No-Lead (QFN) package encountered electricity leakage after Highly Accelerated Stress Tests (HAST) 96 h. Although it is suspected that penetration of moisture into the encapsulated package caused electrical leakage failure, there is no direct evidence to prove this assumption. Traditional X-ray and Scanning Acoustic Microscopy (C-SAM) techniques cannot detect any defect of the package due to their detection limit.To solve above issues, this study employed a new deuterium oxide (D2O) isotope tracing method. The encapsulated package underwent highly Accelerated Stress Tests (HAST) with D2O, and D signal of the sample was analysed by Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS). The results showed that D localized at the failure area where leakage occurred. It is direct evidence to show it is a moisture-induced leakage.

Potential application of Gustatory Receptor 1 (CmegGr1) gene as a molecular marker for identification of Chrysomya megacephala (Diptera: Calliphoridae).

Chrysomya megacephala larvae can easily be identified using cheap traditional microscopy techniques. Nevertheless, identification using taxonomy keys may be hampered, if the morphological characteristics of the larvae are incomplete, or immature for microscopic identification. To overcome the difficulty of species determination, molecular identification has gained relevance and is applied in forensic investigations. This study aimed to identify a novel target gene, known as the gustatory receptor 1 gene (CmegGr1), which has never been used for identification. The third instar larvae of Ch. megacephala (n = 30) and eight other forensically important fly species were obtained from two sources; rabbit carcasses and the Forensic Entomology Unit collection. Their DNAs were extracted and the CmegGr1 gene was amplified using polymerase chain reaction (PCR). The resulting sequences were subjected to phylogenetic analysis. A 209 bp fragment of the CmegGr1 gene was successfully amplified in 80% (24/30) of Ch. megacephala samples, while all of the non-Ch. megacephala species were not amplified. The phylogenetic analysis revealed that the evolutionary tree of CmegGr1 shares many traits with the 21a gustatory receptors of Calliphora stygia and Lucilia cuprina (Gr21a), which are also classified as necrophagous fly species. The high specificity of species identification was demonstrated in the present study using DNA barcoding, which led to the conclusion that the CmegGr1 gene could serve as an alternative marker for identifying Ch. megacephala.

The Feasibility and Treatment Results of Transcanal Endoscopic Myringoplasty

We reported on transcanal endoscopic myringoplasty in 25 cases preliminarily in 2014. Now our number of transcanal endoscopic myringoplasty reached to 209 ears and allowed us to adequately investigate the visibility, necessity of canalplasty, treatment results, and multivariate analysis. A prospective case series. Tertiary referral center. Transcanal endoscopic myringoplasty was performed on 209 ears in 201 patients between 2011 and 2019 and followed up over 1 year. Preoperative endoscopic and microscopic views for the same patient were compared. We examined success rates at 1 year after surgery according to operation type, perforation size, operation side, gender, cause of perforation, and age, and also examined hearing results. Logistic regression analysis was performed to investigate the basic demographic and clinical characteristics of the patients associated with perforation closure. The anterior edge of the preoperative perforation was not visible under microscopy in 14.4% of patients. In contrast, endoscopic views revealed the entire tympanic membrane in one field. However, canalplasty was required in 2.4% of tympanic procedures due to difficulty of manipulation. The overall closure rate for perforations was 90.4%. Logistic regression analysis revealed that age > 11 was the only significant factor associated with perforation closure. The average reduction in air-bone gap was 12.1 dB. The endoscopic myringoplasty produced better visualization, the same or better closure rates, and the same or lower complication rates as compared with traditional microscopic techniques.

Transcanal Endoscopic Tympanoplasty: Our Experience at a Tertiary Care Centre.

Transcanal Myringoplasty can be performed with both microscope and endoscopes. Advancement in endoscopes has started the new era of minimal invasive surgery in otology practice. Endoscopic approach offers improved visualization with wider field of view, easy access to the hidden recesses of the middle ear, avoidance of a postauricular incision and less bony drilling. To report our experience with transcanal endoscopic tympanoplasty for tubotympanic type of COM and to evaluate its outcome in terms of morphological and functional success. Prospective study, conducted during September 2017 to August 2019, including 60 patients of tubotympanic type of COM. All patients underwent transcanal endoscopic type 1 tympanoplasty. Postoperative results i.e. graft uptake (morphological success) and hearing improvement (functional success) were evaluated at 6months. The graft take up rate was 93.33%. Preoperatively mean AB gap was 23.15 ± 7.23dB which was reduced to 11.68 ± 4.65dB at 6month postoperative follow up. The mean gain in AC threshold and AB gap was 15.43 ± 4.37dB and 11.46 ± 1.13dB respectively. Improvement in both AC threshold and AB gap was statistically significant (p < 0.0001). No major surgical or thermal injury related complications were observed. Although both microscopic and endoscopic techniques have their advantages and disadvantages, endoscopic technique can effectively replace traditional microscopic techniques in management of COM with satisfactory outcomes. We infer that EES offers less operative time, less postoperative pain, least complications and less hospital stay thus helping to reduce the physical and psychological burden placed on patients.