The use of an endoscope in otological surgery as compared to using a microscope provides many benefits in terms of visibility and access to the operating region. The disadvantage of using an endoscope is that it has to be handled by the surgeon during the surgery. A novel parallel kinematic mechanism has been proposed recently for manipulating the endoscope during surgery. This paper details the design requirements considered for the optimization of the process, after consulting surgeons with various expertise. The paper further presents the different evaluation strategies that can be used to optimize the design parameters as per the needs of the application. The contribution of the presented work is the implementation of the surgeons' requirements into an objective function and the optimization of a proposed architecture of a parallel kinematic mechanism suitable for otological surgery.