A Novel Articulating Chip-on-Tip Endoscope for Dynamic Middle Ear Surgical Visualization

Objective: To enhance visualization in pediatric Otolaryngology middle ear surgeries and reduce mastoidectomy instances, we introduce a novel Articulating Chip-on-Tip Endoscope (ACoT Endo). Methods: The ACoT Endo incorporates a cable-driven distal end camera and off–the–shelf Chip–on–Tip camera to improve visualization. We compared its capabilities with standard endoscopes, evaluating its bending capacity (70
$^{\circ }$

$\pm$
2
$^{\circ }$
) and center axis rotation (360
$^{\circ }$
). To test the overall functionality of this device, a Mock Ear was created to simulate the anatomy of the human ear, and the ACoT Endo's ability to be used in this cavity is compared to a standard 0
$^{\circ }$
Karl Storz endoscope through tests with the Mock Ear and respective endoscopes. Results: The ACoT Endo accurately captured surgical details similar to standard endoscopes in the ENT field. Compared to the 0
$^{\circ }$
Karl Storz endoscope, the ACoT Endo demonstrated an increased field of view by approximately 69% and captured area by approximately 249%. ACot Endo allowed the surgeon to effortlessly articulate the camera with the rotation of a finger, while an excision tool was inserted in the middle ear, a procedure that is currently extremely difficult with standard endoscopes. Conclusion: The ACoT Endo's dynamic viewing angle and Chip–on–Tip camera enable unparalleled surgical visualization within the middle ear using a single endoscope, offering potential benefits in Otolaryngology procedures. Significance: By reducing the need for invasive mastoidectomies and providing better visualization tools, the ACoT Endo has significant potential to improve outcomes and safety in pediatric middle ear surgeries.