Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 1 2025 08 02 66 73 Tayebe Taghizade Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran Saeid Farahani Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran Ali Kouhi Department of Otolaryngology Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran Ali Balooch Noorimentajhiz Company, Science and Technology Park, Kashan, Iran Alireza Akbarzade-Baghban Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Esmaili Municipality Organization, Qom, Iran 2025 04 24 2025 08 02 Background and Aim: Accurate diagnosis of Middle Ear Effusion (MEE) is a challenging task due to the lack of reliable diagnostic tools available to physicians and audiologists. This study aimed to develop a hyperspectral imaging tympanoscope for diagnosing MEE and evaluate its diagnostic ability. Methods: The tympanoscope system was constructed using an ear endoscope, lens, camera, and near-infrared wavelengths. Its diagnostic ability was evaluated with a middle earmimicking phantom. Additionally, a pilot study was conducted on middle ear images from 10 children (five healthy and five with MEE). Results: Phantom experiments revealed a Weber contrast difference of 0.16 and 0.49 between phantoms with and without fluid in visible otoscopy and hyperspectral tympanoscopy, respectively. As a result, in hyperspectral tympanoscopy, the contrast difference between fluid presence and absence was nearly tripled. Furthermore, in the pilot study, a significant difference was found in Weber contrast between healthy children and those with MEE (p<0.001), with higher contrast in the MEE group. Conclusion: The hyperspectral imaging tympanoscope can quantitatively distinguish between the presence or absence of fluid in the middle ear. It has potential as a diagnostic and monitoring tool for MEE. https://avr.tums.ac.ir/index.php/avr/article/view/1438