To be honest- I never saw the use of of endoscopes with the middle ear, I think it would be too traumatic but if someone knows otherwise I would love to hear.
Puncturing of the tympanic membrane is usually done in a very small incision in the pars tensa, ussualy when you want to drain an AOM. The puncture is made by a special lancet.
If you could attach any info about fiberoptics and middle ears I would love to read it. I like this field of medicine alot.