The need for surgery for a perforation of the tense part of the tympanic membrane of the ear should be determined by the cause of the perforation and the size of the perforation. If the perforation is traumatized and not infected, and the perforation is small in size, it can be observed to see if it heals on its own; if it is accompanied by infection and the perforation is large in size, and difficult to heal on its own, then it requires surgical treatment.
If the perforation is caused by pressure changes in the Eustachian tube or no clear trigger, if there is no infection and the perforation is small, it can be observed for a few weeks, avoiding water intake into the outer ear, and in most cases it will heal on its own without the need for surgery.
If the tympanic membrane is perforated due to middle ear inflammation, infection, etc., and the purulent discharge is often a constant irritant, or if the perforation is really large and the tympanic membrane is difficult to heal on its own, then surgery should be performed.
If perforation of the tympanic membrane is diagnosed, early consultation is recommended to clarify the cause of the perforation and standardize the treatment in order to minimize the adverse effects of the disease.