The goals of surgery for otitis media include removal of the lesion dry ear repair of the tympanic membrane to prevent reinfection, and improvement of hearing. Simple perforation of the tympanic membrane. Hearing can often be improved with repair of the tympanic membrane and reconstruction of the auditory chain when the chain is intact and moving normally. However, not all procedures can improve hearing; if a patient has preoperative combined sensorineural deafness, hearing improvement is very limited. Poor function of the eustachian tube is also a barrier to hearing improvement. The presence or absence of residual auditory tuberosity is also a factor to consider. If the stapes is fixed after removal of the sclerotic foci, it is often necessary to perform a second surgery to improve hearing on the basis of a phase I tympanic membrane repair, because the infected trauma is not suitable for stapes surgery and there is a concern of inner ear infection.