**1. Introduction**

The impressive technological evolution of the last decades and the miniaturization of instruments have allowed to intervene with less invasiveness and better functional results in the field of surgical otology. The introduction of endoscopy with rigid endoscopes, coupled with video processors and high definition monitors, has opened new alternatives to conventional and validated otomicroscopic surgical approaches to the middle ear and avoid external access to various pathologies. Otoendoscopy is gradually taking hold on otology not only in diagnostic approaches but also in surgical aspects. It is well known that the endoscope has the advantage of offering a wider view compared to microscopes.

One of the first endoscopic surgical approaches to the middle ear was described by Thomassin [1]. Thereafter, many articles were published on otoendoscopic surgical procedures. Its limits are related to the lack of a third dimension, and in case of bloody fields, surgery becomes demanding and troublesome. In this chapter, we will discuss our experience developed over the years in endoscopic otology in children starting in 2004 as a diagnostic tool and then gradually as a surgical instrument
