A perforated eardrum can be repaired through a surgical procedure known in medical terminology as tympanoplasty or tympanoplasty. The procedure involves repairing the perforation with a tissue graft to restore the integrity of the tympanic membrane in order to improve hearing. This procedure has been performed for more than 100 years. In the last 40 years, thanks to the advent of the operating microscope, the refinement of microsurgical and grafting techniques, and the introduction of new antibiotics, the success rate of tympanic membrane repair surgery has been as high as 90%, making it a classic procedure, and laying the groundwork for “tympanoplasty”. If the middle ear inflammation is not cured for a long time, or if there is granulation growth, or if there is marginal perforation in the flaccid or tense part of the tympanic membrane, CT scan should be used to clarify the nature and scope of the lesion, and then surgical removal of the lesion and selective tympanoplasty should be performed according to the conditions. Most tympanic membrane perforations are caused by suppurative otitis media and trauma, and most of them can be healed spontaneously with appropriate treatment. Surgery should be considered only when the perforation does not heal for more than 3 months. A preoperative tympanic membrane repair test should be performed to find out whether the auditory ossicular chain is interrupted. The specific method is to make a false tympanic membrane with cotton sheets and paste it on the perforated area, if the hearing improves, it means that the auditory ossicles chain is complete and movable, which is suitable for tympanic membrane repair, if the auditory ossicles chain is fixed or interrupted, according to the condition, it can only be used to do other types of tympanoplasty. Surgery can be performed under local anesthesia, or general anesthesia can be used for uncooperative children or those with high levels of nervousness and fear. The surgery is performed under a microscope, making a small incision in the ear canal to visualize the perforated tympanic membrane, which is repaired using a variety of methods. The materials used to repair a perforated eardrum include the patient’s own temporalis fascia, the cartilaginous membrane of the ear, or an allogeneic dura mater, venous membrane, periosteum, or synthetic biomaterials. Currently, the most commonly used and most effective is the patient’s own temporal muscle fascia. The transplanted temporalis muscle fascia is trimmed to the appropriate shape and size, overlapped with the edge of the perforated tympanic membrane, and can also be reinforced with bio-glue. After surgery, antibiotics are applied to prevent infection, and the new tympanic membrane is tightly bonded to the perforated tympanic membrane after 10 to 14 days, and then gradually thins to a translucent “tympanic membrane”. Due to the development of endoscopic surgery, simple tympanic membrane repair has become simpler. Small and medium-sized perforations can be repaired by taking a small piece of fat from the earlobe, and the scar is very hidden, the following is a series of photographs of a tympanic membrane perforation endoscopic repair. After two weeks of gelatin sponge filling, the transplanted fat is alive and reddish in color, and will gradually transform to the normal tympanic membrane shape in the future.