**Abstract**

Endoscopic assistance is gradually gaining recognition in otology not only for office examinations but also during surgery. The first endoscopic surgical procedure that was started in our institution was endoscopic ventilation tube placement to manage children with stenotic and curved canals. Following this, endoscopy was used in all type I tympanoplasty and stage I cholesteatoma removals with the advantage of avoiding a postauricular or endaural approach. The last application of endoscopic assistance was to better visualize round window and scala tympani via posterior tympanotomy during cochlear implantation. There are several advantages in using endoscopes: the wide view obtained and the possibility to observe areas behind the angle with less invasiveness and its excellent resolution, in addition to its intense light and higher magnification that facilitates teaching and tutoring. The limits of endoscopic surgery are that one hand is always needed to hold the endoscope and the lack of a third dimension. Until miniaturization of 3D systems allow the possibility to work in the narrow external ear canal, in order to overcome the limitation that one hand is dedicated to the endoscope, we will describe the use of an endoscope holder in otologic procedures.

**Keywords:** endoscopy, ear surgery, pediatric otology, chronic otitis media, cholesteatoma, otitis media with effusion, cochlear implantation, myringoplasty, tympanic membrane perforation
