**Conflict of interest**

No conflict of interest is present.

*Endoscopic Ear Surgery in Children DOI: http://dx.doi.org/10.5772/intechopen.84563*

*The Human Auditory System - Basic Features and Updates on Audiological Diagnosis and Therapy*

The first factor is the variation of duration of the same surgery through time. According to our experience, surgical duration decreased with time in all types of endoscopic surgeries especially in ventilation tube positioning and tympanoplasty. For cholesteatoma endoscopic removal, since it was the last to introduce in our daily practice and therefore we were already acquainted with otoendoscopic surgery,

The second factor is expressed by the anatomical results obtained through time. Concerning tympanoplasty, with time, we have experienced less reperforations in the reconstruction of the successive tympanic membranes. For cholesteatoma surgery, we become more confident in cholesteatoma removal from the hidden parts of the tympanic cavity, that is, sinus tympani and epitympanum. Such an experience permitted us to approach the middle ear less invasively such as creating less intra-

Concerning ossiculoplasties, stapedotomies, and cochlear implantation, it is preferable that they are advised after having obtained a certain confidence with

Otosurgery belongs to the micro-surgery procedures. In order to progress through various techniques of otosurgery, the microscope is fundamental to adequately understand the anatomy in its three dimensions. For a beginner, the best choice is to proceed training with both techniques contemporary in order to understand the different perspective of the middle ear. Not all surgeries could be completely done by endoscope, and also in case of a complication or bleeding, a microscope surgery is necessary. For experienced otosurgeons, it is preferable to start their endoscopic surgery with ventilation tube placement then move to myrin-

Endoscopy as a diagnostic and surgical tool in otology is now a valid instrument for different pathologies of the ear. Indications for solely endoscopic surgery should be well planned. Before starting endoscopic surgery, one should have good preparation in using the operating microscope and in certain surgeries should always be present in the operating theater. There are still some limits to endoscopy that in the future will be overcome thanks to technological advances such as miniaturization of 3D systems.

duration of surgery did not undergo a tangible reduction.

canal atticotomy or removing intact ossicles.

**9. Surgical training and young surgeons**

goplasty and therefore to cholesteatoma removal.

otoendoscopic surgery.

**10. Conclusions**

**Conflict of interest**

No conflict of interest is present.

**130**
