In terms of current technology and medical trends, surgery is likely to be the treatment of choice in the next 50 years or less. However, the trauma of surgery will be further reduced, and it is possible to gradually transition from the current invasive microscopic surgery to minimally invasive endoscopic surgery or even to gradually expand the development of non-invasive endoscopic surgery for otitis media due to the development of bioengineering medicine. As for the current situation, the treatment of otitis media is still at a relatively backward stage, and the main equipment for surgery is a microscope. Dr. Zheng has summarized the defects of microscopic otitis media surgery in several articles, and interested readers can read Dr. Zheng’s previous articles on the subject. The minimally invasive technology for otitis media that is currently emerging internationally is a new generation of technology represented by otolaryngoscopic technology. The first academic conference on otolaryngoscopic surgery worldwide was held in Dubai in 2015. The 2015 National Conference on Otolaryngology, Head and Neck Surgery of the Chinese Medical Association was held in Hangzhou at the West Lake with a special session on the future of otolaryngology in which professors from Hong Kong and Taiwan were invited to make presentations on the development trend of otolaryngoscopic surgery. The above signs and Dr. Zheng’s practical experience in minimally invasive otolaryngoscopic surgery indicate that minimally invasive otolaryngoscopic technology is the future trend and mainstream method of otitis media treatment. In the area of minimally invasive otoscopic surgery, Dr. Zheng has been engaged in exploration for more than ten years. From the earliest endoscopic examination to the current very comprehensive endoscopic minimally invasive surgery and to a lesser extent, endoscopic non-invasive surgery. At present, it is technically more mature. Although the advantages over traditional microscopic surgery are obvious and patient satisfaction is very high, for an otolaryngologist who regards technology and innovation as his life, Dr. Zheng himself feels that there is still a lot of room for future exploration and improvement. These innovations and improvements will certainly be an important part of the future surgical treatment of otitis media and represent one of the trends of future technological development. The following is a discussion of Dr. Zheng’s own work on the future surgical treatment trends for otitis media, divided into two parts: endoscopic minimally invasive otitis media treatment and endoscopic non-invasive otitis media treatment to express some personal views. Minimally invasive endoscopic otitis media will definitely develop in the direction of no incision, no ear canal filling, fewer follow-up visits, and less antibiotics and other medications in the future. No incision is the basic requirement for minimally invasive otitis media surgery, and Dr. Cheng has basically achieved this, which is the most satisfying point for patients. The idea of no filling of the ear canal is a solution to the paradox that foreign patients cannot come to the follow-up clinic to take the filling after otitis media surgery, while local patients cannot take it due to the conditions. It is necessary to reduce the number of follow-up visits. Nowadays, life is very fast-paced and everyone is very busy, so going to the hospital 1-2 times a week is a disaster for most people. Currently, Dr. Cheng’s patients basically have 2 follow-ups every two weeks after surgery. Then one follow-up in January, February and March, which is a significant reduction in the number of follow-ups compared to traditional microscopic otitis media surgery. The reduction of postoperative antibiotics is necessary. Currently, we are using too many drugs after otitis media surgery, both in terms of the type of drugs used and the amount of drugs used. Previously, 2-4 weeks of antibiotics were typically used post-operatively, but Dr. Cheng has now reduced the amount of antibiotics to 1-2 weeks. The goal for the future is to gradually eliminate intravenous or oral antibiotics. Endoscopic non-invasive otitis media surgery has the potential to become an alternative to minimally invasive otoscopic otitis media surgery in the future. For the non-invasive technique, Dr. Zheng is currently using it mainly in patients with tympanic membrane perforations of less than 4 mm. In the future, with the development of biomaterials and the application of various biological factors, it is possible to use the endoscopic non-invasive otitis media technique to solve the problem for the vast majority of otitis media, which will further reduce the trauma of surgery for patients. The development of non-invasive technology may lead to the advent of the era when otitis media treatment will eventually not require surgery and can be cured by an outpatient examination. The future treatment of chronic otitis media will be the rapid development of minimally invasive and non-invasive otoscopic technology, with non-invasive technology gradually replacing minimally invasive technology for otitis media, and surgery gradually being done on an outpatient basis without the need for hospitalization and without the need to take large amounts of antibiotics after surgery.