Chronic suppurative otitis media has a slowly progressive and progressively worsening pathology. In the early stages of the disease there may only be tympanic membrane perforation with inflammatory edema of the middle ear tympanic chamber mucosa. Effective anti-infective treatment can confine the lesion to the tympanic membrane and chamber, manifesting as tympanic membrane perforation and mild hearing loss. At this stage, if the infection is actively controlled and surgery is performed promptly after the dry ear, not only is the scope of surgery smaller and the time required shorter, but the risk of surgery is also somewhat lower. Patients usually have better hearing and very little recurrence of drainage after surgery. If treatment is not given early, with repeated episodes of otitis media and constant stimulation of purulent secretions, inflammation spreads deeper and deeper, granulation tissue forms in the tympanic chamber and sinus and mastoid process, the channels for ventilation and drainage of the middle ear cavity are blocked by granulation, inflammation gradually worsens, anti-infection treatment is not effective, and the ear is in a state of pus or moisture for a long time. In this case, the tympanic membrane perforation is enlarged, and the auditory tuberosity may be destroyed or wrapped in granulation, or the sclerotic foci may be formed so that the auditory tuberosity is fixed, and hearing loss is obvious at this time. The combination of middle ear cholesteatoma will further aggravate the condition, and destruction of the facial nerve canal and inner ear vagus may occur, as well as the combination of neurological deafness. It is important to note that as the course of chronic otitis media increases, the function of the eustachian tube becomes irreversibly damaged, causing the middle ear cavity to lose its ability to maintain normal air pressure and keep the eardrum in its normal position. Surgical treatment at this stage not only expands in scope, but also increases in difficulty and risk. This is because as the condition worsens, surgery is aimed at removing lesions in the tympanic cavity, sinus, mastoid process and around the auditory tuberosity and pharyngeal canal area, and performing autologous or artificial auditory bone hearing reconstruction, or second-stage auditory bone reconstruction, as appropriate. The postoperative outcome depends not only on the surgeon’s surgical technique, but also on the extent, nature and severity of the middle ear lesion and the functional status of the eustachian tube. It follows that surgical treatment of chronic suppurative otitis media should be performed as early as possible.