Telemedicine includes all medical activities involved in diagnosis, therapeutics or social medicine undertaken by an electronic transfer medium. This technique requires the transmission of visual and acoustic information over long distances and does not require the specialist to be personally present at the requested consultation. In the last few years, the digital data transmission, e.g., ISDN (ISDN (integrated Service Digital Network), has become available and has facilitated the use of telecommunication. Recently, the real-time transmission of acoustic and visual signals will be improved by use of asynchronous transfer made (ATM). Advanced telecommunication applications in minimally invasive ENT surgery are experimental in most cases. We can distinguish three different telesurgical developments: surgical teleconsultation, surgical teleassistance,and surgical telemanipulation. The different applications and transmission media are explained and discussed.