In our clinical work, we often encounter patients with otitis media who ask the question, “Is there any medicine to cure my otitis media? “Do I need an operation for otitis media? “Do I have to wait until my otitis media stops flowing before having surgery? Questions such as these are encountered almost every day. In fact, chronic otitis media is a common inflammatory disease in otology clinics. With the improvement of people’s living standards, otitis media has become more and more important to people because chronic otitis media not only has long-term pus flow, but also the pus flow may be accompanied by an unpleasant odor and may lead to hearing loss, which directly affects the quality of life of patients. Some patients may also develop middle ear cholesteatoma, which may lead to intracranial and extracranial complications such as facial palsy, vaginitis (causing vertigo, nausea and vomiting) and even meningitis and brain abscess due to the erosion of the surrounding bone by the cholesteatoma. In my clinical work for many years, I have encountered some very typical cases. Once I asked a patient with middle ear cholesteatoma about his condition during a ward visit. I had the patient undergo an MRI of the brain, which revealed an intracranial brain abscess of about 4 cm in diameter, causing his speech dysfunction – he could understand others but could not speak himself, and his life was in danger at any time. After surgery to remove the cholesteatoma and brain abscess, the patient’s life was saved and he fully recovered two months later. On the other hand, the symptoms of brain abscess due to the abuse of antibiotics are not as typical as described in the textbooks. In another case, a 78-year-old woman was admitted to the emergency room with vertigo, nausea, vomiting, and facial palsy (commonly known as “crooked mouth and slanted eyes”), which turned out to be caused by two complications of cholesteatoma, vaginitis and facial palsy. Many patients think that they can get a cure by simple medication. This is actually where the misconception of otitis media treatment lies, as medication only provides temporary relief, so called treating the symptoms but not the root cause. In fact, only through modern ear microsurgery can we hope to completely solve the problem. The purpose of microsurgery for otitis media is threefold: first, to completely remove the lesion and obtain a “dry ear” (rather than a chronically runny ear); second, to prevent some of the serious complications caused by otitis media, such as facial palsy, meningitis and even brain abscess; and third, to restore or partially restore the damaged hearing through surgery. One may ask if the surgery is safe? In fact, this microsurgery is very safe and risk-controlled in regular hospitals because ear microsurgeons are generally trained in rigorous temporal bone dissection. Regarding the timing of surgery for otitis media, patients often ask online and in outpatient clinics whether they should wait until there is no pus flow before surgery. It is important to know that chronic otitis media is characterized clinically by long-term, recurrent pus flow and a trend of hearing loss. For patients with good hearing and simple tympanic membrane perforation, tympanoplasty can be chosen when there is no pus flow. For those with significant hearing loss, often accompanied by repeated infections and pus flow, the ear is difficult to “dry”, and it is difficult to cure completely without surgical treatment. There are a variety of surgical options available to the surgeon, and as long as it is not an acute inflammatory period, there is no need to wait for a “dry ear” before operating. The specific surgical methods include tympanoplasty, wall-mounted tympanoplasty with preservation of the auditory bone, and open tympanoplasty with artificial bone. Sometimes the lesion is very serious and has to be staged, this, I and foreign practice is different, in order to minimize the financial burden of patients, save time, in most cases my practice is to remove the lesion and reconstruction of hearing in the same phase to complete (Phase I), but some patients after surgery hearing recovery is still not very satisfactory, this is due to the new tympanic membrane and hearing bone time connection may be some misalignment, then This is due to a possible misalignment of the temporal connection between the new tympanic membrane and the auditory bone. If the surgery is done in two stages, the hearing may be better, but the patient needs to be hospitalized twice, which will increase the financial burden and delay some time, so the doctor often does some communication with the patient before the surgery, so that the patient can choose the surgery plan by himself.