While microsurgical techniques have already become common knowledge in ENT surgery, a new era has begun with the development of endoscopic surgery. Thereby, however, structures on the opposite side are seen best, not those which have already been examined by the endoscope. One solution to this problem is a biportal approach to the middle ear. Filling an essential gap in anatomical and ENT literature, this atlas shows the various approaches to the middle ear, e.g., through the tympanic membrane or through the Eustachian tube, which allow safe surgical manipulations. Written for: Surgeons (ENT, neurosurgery) Keywords: Endoskop Eustachian tube Eustachische RĂśhre Minimal Invasive Surgery Minimal invasive Chirurgie Mittelohr Trommelfell biportal approach endoscope tympanic membrane