Endoscopic progress: Endoscopy started late in China, and it was only after the 1990s that some scholars adopted endoscopy as an adjunct to surgical operation. Microsurgery of the ear began in China in the 1950s, and played a positive role in the complete removal of middle ear and mastoid surgery lesions and the restoration of hearing function after middle earplasty. Stapedioplasty is suitable for small lesions in the front 1/3 of the stapes floor, where the front of the stapes can be visualized under the guidance of a fine fiber-guided endoscope, the front foot of the stapes can be vaporized with an argon laser, and the floor can be cut off behind the sclerotic foci of the stapes floor, the posterior part of the stapes can be loosened, and the incision window can be covered with a cartilaginous coat. This procedure eliminates the need for a piston stirrup and preserves the stirrup tendon and the annular ligament, reducing postoperative sensorineural deafness, vertigo, granulation tissue formation, and anvil necrosis caused by a piston stirrup. Preserving the stapes tendon improves speech recognition in background noise and reduces auditory hypersensitivity. Preservation of the circumferential ligament enhances protection during exposure to strong noise. In conventional middle ear surgery, the microscope does not adequately expose the posterior tympanic chamber, stapes, and surrounding structures, and in some patients, the eustachian tube opening is difficult to expose, causing inconvenience to the surgical operation. The intraocular microscope is a good solution to the shortcomings of the surgical microscope and has the potential to achieve minimally invasive results. Studies have shown that endoscopic surgery via different routes can clearly visualize the structures of the middle ear, thus improving the clearance rate of cholesteatoma and thus reducing the recurrence rate of cholesteatoma. In ear neurosurgery, endoscopy can better reveal the nerves and blood vessels in the pontocerebellar horn and the extent of the lesion, providing valuable information for microscopic surgery to remove the tumor. Of course, there are deficiencies in endoscopy such as unclear field of view during bleeding, one-handed operation, and lack of stereo vision, which need to be explored and improved continuously.