Many patients are very afraid of tympanic membrane perforation due to otitis media. In fact, tympanic membrane perforation in otitis media can be seen as a protective drainage mechanism of the organism. Let’s take a familiar example from everyday life to illustrate this point. After a few days of redness, swelling, and pain, the boil may “cook”, that is, a pus head may appear, and the pressure may increase further, and the pus head may spontaneously burst and form a crater. The crater is filled with scar tissue, covered by epithelial tissue, and the lesion is healed. In essence, acute suppurative otitis media is similar in that the pus is equivalent to lava and the tympanic membrane perforation is equivalent to a volcanic eruption, forming a crater. As acute suppurative otitis media progresses further, the middle ear cavity is gradually filled with pus. As the pressure in the middle ear increases due to the increasing pus, the tympanic membrane separating the middle ear from the outside world is compressed and becomes necrotic and ruptures, forming a tympanic membrane perforation, through which the pus in the middle ear flows after the perforation. At this point, the various symptoms of otitis media are rapidly relieved, and most suppurative otitis media undergo such a developmental process. As the inflammation quiets, most tympanic membrane perforations heal through the body’s own tissue repair process. In children and a few adults, because the tympanic membrane is thicker and less prone to perforation or has only very small perforations, the pus that accumulates in the middle ear has difficulty flowing out, so the increased pressure causes severe deep ear pain; this in turn causes severe damage to the auditory chain, facial nerve and other tissues in the middle ear cavity, leading to disruption of the auditory chain and facial paralysis; the pus in the middle ear cavity may also flow behind the ear or into the brain, causing severe postauricular abscesses or fistula, and even lead to intracranial complications such as septic encephalitis and meningitis that endanger the patient’s life. Just as doctors actively intervene in mature boils by incising and draining them, in some children who suffer from acute purulent otitis media with middle ear pus accumulation but delayed perforation of the tympanic membrane, performing tympanotomy can facilitate smooth drainage, facilitate rapid dissipation of inflammation, and prevent serious complications from occurring, when the perforation of the tympanic membrane is beneficial instead.