SummaryProgressive miniaturization of rigid and flexible endoscopes enables the practising otorhinolaryngologist (head and neck surgeon) to visually inspect regions of the upper respiratory tract that could never have been inspected directly before, or had only been accessible for direct view by massive traumatization of the anatomic surroundings. For the otologist, microendoscopy opens up the possibility of using an endoscope to assess the luminal situation of the Eustachian tube, in order to detect morphological obstructions of this normally collapsed connection between the middle ear compartment and the nasopharynx. The first basic laser surgery on polyps and oedematous soft tissues to restore the essential proper ventilation and drainage of the tympanic cavity have been performed and data about this topic are soon to be published. The ‘mother-baby endoscope’ technique allows us to reach into the nasopharynx and paranasal sinuses via the natural orifices, for a direct visual diagnosis of chronic secretory and polypous rhinosinusitis. Even small recurrences can be treated using minimally invasive techniques by fibre-delivered laser surgery in hidden areas of facial skull cavities. This painless technique is particularly useful in children. The development of ‘sialendoscopy’ i.e. microendoscopy of the salivary glands, is the first procedure to identify the real cause of obstructive disorders of the major salivary glands. Direct visual inspection allows the examiner to differentiate between stenoses, secretion plugs and calculi. In cases of sialolithiasis, laser-induced shock wave lithotripsy (LIL) can be performed by transferring short laser pulses via an inserted fibre onto the surface of the stone to disintegrate it.