The symptoms of acute suppurative otitis media are very different before and after tympanic membrane perforation, and the common symptoms are as follows: 1. Systemic Symptoms: Before tympanic membrane perforation, the patient’s systemic symptoms are more obvious, and there can be chills, fever, lethargy, and loss of appetite, and the children’s systemic symptoms are usually more serious than those of the adults, and they are accompanied by high fever, convulsions, and gastrointestinal symptoms such as vomiting and diarrhea, etc. The temperature of the body will gradually decrease after the tympanic membrane perforation, and the systemic symptoms will also decrease significantly; 2. Ear pain: ear pain is the earliest symptom of most patients, patients can have a dull pain or throbbing pain in the deep part of the ear, and the pain can be radiated to the frontal, temporal, parietal, dental, or even the whole half side of the head through the trigeminal nerve, and the ear pain is usually aggravated when the patient swallows, coughs, or sneezes, and the patients with severe ear pain are usually unable to sleep at night, and they are irritated and restless. Infants and young children are crying, once the tympanic membrane appears spontaneous perforation or do tympanotomy, pus outflow, pain symptoms can be reduced immediately; 3, tinnitus and hearing loss: the affected side of the ear will have pulsatile tinnitus and hearing gradually decline, earache patients can appear mild deafness, usually not noticed by the family, when the tympanic membrane perforation, hearing instead of the previous increase, if the lesion invades the inner ear, there can be a deafness. If the lesion invades the inner ear, vertigo as well as symptoms of sensorineural deafness can occur; 4, ear leakage: after the tympanic membrane perforation and the outflow of fluid from the ear, due to the pressure in the middle ear is relieved, initially it is a plasma-blood ooze, and then it changes into mucus and pus, if the amount of secretion continues to increase, it suggests that secretion is not only from the tympanic chamber, but also from the sinus or mastoid.