Minimally invasive surgery for otitis media is currently the most advanced surgical technique for the treatment of chronic suppurative otitis media and cholesteatoma-type otitis media. This technique has the advantages of no skin preparation and hair shaving before surgery, no incision on the body surface during surgery, no medication change after surgery, high success rate, few complications, and good hearing protection. Although Dr. Zheng has been exploring minimally invasive surgery for otitis media for about ten years, minimally invasive surgery for otitis media is still mysterious and difficult to understand for the majority of ear surgeons and otitis media patients. That is why Dr. Zheng has written the story of myself and every patient who underwent minimally invasive otitis media surgery in the form of a continuous chapter book. One is to leave a treatment file for each patient who has undergone minimally invasive otitis media surgery, so that if any problems arise in the future, Dr. Cheng and the patient can work together to find the cause and solve them. Another purpose is to provide a reference for other patients and medical colleagues to dispel the mystery of minimally invasive otitis media surgery. It is hoped that with Dr. Zheng’s vigorous exploration and promotion, minimally invasive surgery for otitis media can be popularized in most hospitals in China in ten to twenty years’ time, benefiting the majority of otitis media patients. Patient Tang, female, 61 years old. She was admitted to the hospital for left-sided cholesteatoma type otitis media. Since the patient’s hearing was mixed deafness, the lateral wall of the tympanic chamber had epithelialized, the main requirement was a dry ear without pus, and the possibility of hearing improvement was very small, radical surgery of the mastoid process was done. The majority of patients who have the possibility to improve their hearing have to do hearing reconstruction, but those who have poor conditions and severe damage will not be able to do the surgery to improve their hearing and will be treated directly. In this case, the patient’s middle ear condition was very poor, and he did not have high hearing requirements. The surgery was done under general anesthesia, and the entire surgery was a minimally invasive mastoid surgery with small incisions. In fact, for a very mature ear surgeon, mastoid surgery is supposed to be very fast and can usually be controlled within an hour and a half. Surgery is a manual technique, and like any technique, it requires skill and perception. Patients often ask Dr. Cheng whether the middle ear surgery is risky and whether there is a chance of facial paralysis. The main reason is that each surgeon’s skill varies greatly, and the difference in skill and perception of each surgeon leads to a great difference in the risk of surgery. Therefore, the most important thing is to find a good ear surgeon to prevent and control the risk of surgery. After the surgery, the old man was in good spirits and there were no complications such as facial paralysis.