Some people think they have otitis media when they find pus in their ears. In fact, there are many diseases that cause ear pus, such as otitis externa, external ear canal boils, external ear canal eczema with infection, chronic tympanitis, and acute and chronic purulent otitis media. Therefore, you should see a doctor for symptomatic treatment after ear discharge, and do not use random medication on your own. What should I do if I have chronic suppurative otitis media? First, let’s understand the manifestation of chronic otitis media, which is characterized by long-term or intermittent pus flow in the ear, tympanic membrane perforation and hearing loss. Clinically, there are three types: 1 simple, 2 osseous granulomatous, and 3 cholesteatomatous. Of these, type 1 has better consequences, generally does not cause serious complications, and can stay with the patient for life. Type 2 and 3, especially the cholesteatoma type, can destroy bone and invade adjacent important structures, causing serious intracranial and extracranial complications and endangering life, such as meningitis, brain abscess, facial palsy (crooked mouth), and labyrinthitis (which can cause hearing loss and vertigo), which is commonly referred to clinically as a “time bomb” hidden in the ear. Therefore, surgery should be performed as early as possible for chronic suppurative otitis media types 2 and 3, while for type 1 chronic suppurative otitis media, surgery is also recommended if available. However, if there are very few episodes of pus flow and the hearing is still good, and there are no conditions for surgery, regular observation is possible. Some doctors talk too much about the danger of otitis media, as if otitis media will cause serious complications and endanger the life of the patient, which is not true. Regarding surgery, type 1 chronic suppurative otitis media is mainly about repairing the eardrum and rebuilding hearing. The following conditions should be achieved as much as possible before surgery: the function of the eustachian tube is basically normal or can be restored, a simple test is the presence or absence of drug smell in the mouth for a shorter period of time when drops are placed in the ear; no severe sensorineural deafness; and dry ears for more than 2 months. Since the cost of surgery and the length of hospital stay are not a small burden for the patient, the doctor should master the conditions of surgery to improve the success rate. As for type 2 and 3 chronic suppurative otitis media, the main purpose is to remove the lesion and reconstruct middle ear hearing in stages or phases if available, but not reluctantly. In some patients with poor middle ear conditions, reluctantly performing a stage of lesion removal + hearing reconstruction not only fails to improve hearing, but also leads to recurrence of otitis media.