In ENT clinics, we often see patients with different types of tympanic membrane perforations. Some of them are perforated by acute otitis media due to colds, or perforated by ear digging; some babies and children have pus in their ears after vomiting milk due to improper breastfeeding; even being hit in the ear by a ball or hand while playing ball, being scraped in a quarrel, or having their ears shocked by firecrackers can cause tympanic membrane perforation; occasionally, insects can also enter the ear and cause tympanic membrane perforation, which makes the middle ear open to the outside world, and bacteria can easily enter and cause otitis media when swimming, washing hair or digging. Repeated otitis media can increase the size of the eardrum perforation and harden the middle ear adhesions, causing further hearing loss. If medication is not used properly, it can also cause the nerve function of the inner ear to decline, making it more difficult to treat. More seriously, repeated inflammation of the middle ear can lead to osteochondritis or cholesteatoma-type otitis media, which can lead to intracranial and extracranial complications such as facial nerve palsy, meningitis, and brain abscess when the bones are eroded, and can even be life-threatening. If a tympanic membrane perforation is found, the site, scope and cause of the perforation should be checked immediately at an ENT specialist. If necessary, electro auscultation and binaural papillography should be performed. If there is osteochondritis or cholesteatoma type otitis media, surgery should be done as soon as possible to remove the lesion and prevent complications; if the middle ear is only a simple inflammation, timely and reasonable treatment should be given to make it dry as soon as possible. For patients with tympanic membrane perforation and no pus flow, the doctor will examine whether tympanic membrane repair can be performed. It is best if the tympanic membrane can be repaired, as it will not only improve hearing, but also re-establish a barrier to prevent recurrent otitis media and avoid ototoxic damage caused by long-term use of ear drops. There are three ways to treat tympanic membrane perforation: 1. If middle ear inflammation has pus flowing from the outer ear, anti-inflammatory treatment should be given, oral antibiotics should be taken in the acute stage, and 2.5% chloramphenicol ear drops or 0.3% ofloxacin ear drops should be used locally as an ear bath. 2. If the perforation is not infected due to trauma, sterilized dry cotton balls can be used to plug the ear canal and antibacterial agents can be used to prevent infection. 3.Health care after medication is also very important, such as not to enter water in the ear, etc. 4. If the tympanic membrane perforation has not healed after 2 to 3 months of treatment, a specialist examination should be done and tympanic membrane repair should be performed if necessary to improve hearing. 5. If the tympanic membrane perforation has not healed after 2 to 3 months of treatment (traumatic perforation for 1 month), a specialist examination (including otoscopy, hearing, nasal cavity, nasopharynx and eustachian tube function examination) is required. If available, tympanoplasty can be performed to preserve or improve hearing. For middle ear inflammation that has not been treated for a long time or has granulation growth, or marginal perforation in the loose or tense part of the tympanic membrane, the nature and extent of the lesion should be clarified by X-ray or CT scan, and the lesion should be surgically removed to obtain a dry ear first, and then tympanoplasty should be performed selectively according to the conditions. Traumatic perforations may heal on their own, but if they do not heal on their own after 1~2 months, surgical treatment can still be performed according to the above conditions. For those who do not want to repair the eardrum, or for those who cannot repair the eardrum for the time being due to their young age, poor health or long distance, the following points should be borne in mind: 1) Waterproof the ears, no swimming, and use sterilized cotton balls to plug the ear canals when washing hair or bathing; 2) Dig the ears carefully, as bacteria can easily be brought in by digging with unclean instruments; 3) Prevent colds, as otitis media attacks are usually caused by colds; 4) Prevent improper nose blowing If you pinch the two nostrils and force the nasal discharge, it is easy to squeeze the nasal secretions through the eustachian tube to the middle ear and cause inflammation, you should block one nostril and gently spray nasal discharge; 5, strengthen nutrition, exercise properly, pay attention to rest and improve immunity; 6, go to the hospital for regular checkups and deal with problems early.