A variable direction of view endoscope is positionable at desired locations within the ear, nose, throat, paranasal sinuses or cranium to accomplish visualization. A method of use includes introducing the variable direction of view endoscope into a nasal cavity with the endoscope adjusted to a first direction of view between about 0 degrees and about 15 degrees relative to a longitudinal axis of the endoscope. A therapeutic device is introduced into the nasal cavity and the endoscope is adjusted to a second direction of view directed toward the sinus opening or passageway. The method also includes advancing the therapeutic device into or through the sinus opening and viewing at least one of the sinus opening or passageway or the therapeutic device using the endoscope adjusted to the second direction of view.