If you find pus and running water in your ears, it is likely that you have purulent otitis media. It is recommended to go to the hospital as soon as possible to receive a specialist examination, which mainly includes the following aspects: 1. Detailed introduction of their medical history and symptoms to the doctor: pay special attention to the time and progress of hearing loss, the presence of vertigo, headache, and a history of crooked mouth. 2, the doctor will do a comprehensive otolaryngology specialist examination for the patient: check the middle ear pus trait, check the position and size of the tympanic membrane perforation under the ear endoscope or microscope, whether there is any granulation formation in the external auditory canal and the middle ear drum chamber, and whether there is any cholesteatoma generation. 3, the need for audiological examination: including pure tone hearing threshold determination (commonly known as “electric audiometry”), middle ear analysis (acoustic impedance, stapedius muscle reflex), etc., through the hearing examination can be a preliminary judgment of otitis media on the degree of auditory damage, and according to the preliminary estimation of whether there is no auditory ossicular chain damage, whether there is a combination of neural deafness and so on. 4, ear film (mainly temporal bone spiral CT examination): can view the scope and degree of middle ear lesions, especially whether there is no damage caused by the auditory ossicles, facial nerve, tympanic ventricle canopy, the inner ear canal, sigmoid sinus and other important structures, and initially determine the nature of the middle ear lesions, such as cholesteatoma or general inflammation of the granulomatous. High-resolution spiral CT examination is of great help in the diagnosis of otitis media and the selection of surgical methods, and magnetic resonance imaging (MRI) examination is also needed to help determine the few cases of suspected invasion of the meninges. 5.Laboratory tests: The pus from the middle ear is taken for bacterial culture and drug sensitivity test, in order to clarify the type of bacteria causing the infection and the best antibiotic. 6, tissue biopsy: if the nature of the middle ear granulation-like tissue is unknown, sometimes it is also necessary to clamp part of the tissue for pathological biopsy, which can help determine whether the proliferation of tissue is a malignant tumor or benign inflammatory granulation tissue.