A tympanic membrane perforation, as the name implies, is a break in the eardrum and is very common in clinical practice. Most perforations are left over from acute otitis media, or are caused by trauma. Some people classify it as a chronic otitis media because it often bleeds when the ear is waterlogged and resistance is reduced. Others call it a sequelae of chronic otitis media because the ear is dry and seizure-free for a long time. Regardless of which category it falls into, the common feature of tympanic membrane perforation is that it causes varying degrees of hearing loss. The tympanic membrane is a barrier between the middle ear and the outer ear, preventing the entry of water, bacteria and dirt, and is also an important structure for sound transmission. Once the tympanic membrane is perforated, the structures in the middle ear – the auditory tuberosity (the smallest bone in the body, responsible for conducting sound to the inner ear), the eustachian tube (the passage between the middle ear and the nasopharynx, which maintains the pressure balance in the middle ear cavity), the round window membrane (a small window in the inner ear that facilitates the transmission of sound energy in the inner ear), and the facial nerve canal (through which the facial nerve travels) – are exposed to the air and can easily become infected. At the same time, the effectiveness of sound transmission is reduced because the effective vibration area of the tympanic membrane is reduced. A significant number of people do not take tympanic membrane perforation seriously, but it does cause a decrease in quality of life. First, because of the tympanic membrane perforation, you cannot swim, wash your hair or bathe in water, which causes a lot of inconvenience. Once infected, it is unsightly to have wetness in the ear or pus and eczema in the outer ear. If the pus flows repeatedly for a long time, sarcoma or even cholesteatoma will grow inside the tympanic chamber, which will be more difficult to cure. Second, tympanic membrane perforation causes hearing loss. The larger the perforation, the more pronounced the hearing loss, and the more episodes, the more severe the hearing loss. It affects the reception of information, and in mild cases, the quality of the senses is reduced by not being able to hear many subtle sounds, such as music appreciation, and in severe cases, communication is inconvenient. Tympanic membrane repair, also called tympanoplasty, is a routine procedure in otology. The goal of the procedure is to rebuild the middle ear barrier and improve hearing to varying degrees. Many factors affect the success rate of tympanic membrane repair, such as too large a perforation, recent infection, poor eustachian tube, and calcified spots on the tympanic membrane. Therefore, if a small perforation is not healed for more than 6 months or a large perforation is not healed for more than 2-3 months, early surgery should be performed to repair the eardrum to avoid further hearing loss and recurrent pus flow.