The purpose of surgery for otitis media: to remove the lesion, dry the ear (stop the flow of pus), repair the tympanic membrane to prevent reinfection, and improve hearing. In the case of simple tympanic membrane perforation, when the auditory chain is intact and moving normally, the patient’s hearing loss is minimal, and repairing the tympanic membrane and hearing is often slightly improved, but it prevents recurrent infections, and should also be done as early as possible to prevent the problem before it happens, and not wait until the middle ear lesion is aggravated, the auditory chain is damaged, and the hearing loss is aggravated. If the hearing chain is severely broken and fixed, the patient’s hearing loss is severe, and the tympanic membrane needs to be repaired and the auditory chain reconstructed, and the hearing will improve significantly with the replacement, but in the best case, the hearing threshold can be increased to 30 dB. However, not all surgeries can improve hearing, and if the patient has preoperative combined sensorineural deafness, the hearing improvement is very limited. Poor function of the eustachian tube is also a barrier to improving hearing. The presence or absence of residual auditory tuberosity is also a factor to consider. If the stapes is fixed in tympanosclerosis, and the stapes is still not moving well after removal of the sclerotic foci, it is often necessary to perform second-stage surgery to improve hearing on the basis of the first-stage tympanic membrane repair, because the infected trauma during the first-stage surgery is not suitable for stapes surgery, otherwise it will cause inner ear infection and lead to neurogenic deafness or even total deafness, so second-stage surgery is needed.