Chronic suppurative otitis media (commonly known as otitis media) is the most desired thing: no more pus in the ear and stable and practical hearing. In addition to repeated ear pus, hearing loss, there are other hazards? The answer is yes. Chronic suppurative otitis media is divided into three types: simple type, bone ulcer type and cholesteatoma type. The latter two types are both dangerous and can be complicated by complications such as postauricular subperiosteal abscess, labyrinthitis (vertigo), sensorineural deafness, facial paralysis, meningitis, and brain abscess. So, how can you find a safe island for your ears to avoid harm? First, seek medical attention. Almost all patients with osseous ulcer type and cholesteatoma type otitis media have a history of several years, ten years or even decades of recurrent ear pus. The stimulation of bacterial toxins and the erosion of osteolytic enzymes cause the destruction of the tympanic membrane, the auditory ossicular chain, the facial nerve, the semicircular canals, the cerebral plate and other important structures. In mild cases, it causes interruption of the sound transmission mechanism; in severe cases, it causes serious complications such as facial paralysis, vertigo, severe deafness, meningitis and brain abscess. Disease is indeed hateful, but it also leaves us time to overcome it. If we are in the early or earlier stages of the disease-acute or simple otitis media, at this time it only manifests itself as perforation of the tympanic membrane, mucous membrane lesions in the middle ear mastoid, and no bone destruction has occurred. With standardized medication and surgery (tympanoplasty), it is possible to repair the perforated eardrum, cut off the source of infection, and find an island of safety for our ears. This is the preferred option, with the least cost to our patients and friends, the least labor to our doctors and friends, and the best treatment results, most in line with the concept of health economics. Second, smart medical treatment. The art of war says, know your enemy and know yourself, and you will not be in danger in a hundred battles. We are fighting against the disease, we should know a little bit of the art of war, know some of the disease’s current treatment progress, so as to know oneself and the enemy. Our ears are divided into the outer ear, middle ear and inner ear. In chronic suppurative otitis media, the lesions occur in the middle ear. The structure of the middle ear includes the eardrum, hammer bone, anvil bone, stirrup bone (three smallest bones in the human body to form the auditory ossicles chain), and the facial nerve, tympanic cord nerve, sigmoid sinus through which the semicircular canals, cochlea is located in the inner wall of the tympanic chamber, and temporal lobe of the brain and the tympanic chamber compared to the top of the wall neighboring. Sound waves pass through the tympanic membrane, the auditory ossicle chain to reach the stapes footplate, and when they are transmitted to the inner ear, the sound energy is increased by 22.1 times, which is equivalent to a sound pressure level of 27 decibels. Chronic suppurative otitis media firstly causes the destruction of the sound transmission mechanism, which is manifested as conductive deafness; when the lesion further develops (like bone ulcer type and cholesteatoma type) and invades into the facial nerve, the semicircular canals, the cochlea, the sigmoid sinus and the brain, then it will be complicated by facial paralysis, vertigo, sensory deafness, sigmoid sinus thrombophlebitis, meningitis and even brain abscess, which will seriously affect the patient’s quality of life and the safety of the patient’s life. For osseous and cholesteatoma otitis media, the classic surgical approach is mastoidectomy, which aims to remove the lesion, smooth drainage and prevent complications. The postoperative manifestation is that the tympanic chamber, tympanic sinus, and mastoid are fused into one large cavity, and all other sound-transmitting structures except the stapes are removed. Hearing is usually around 60 decibels, which is considered moderately severe deafness, and the patient will have communication difficulties. The development of modern otosurgery has given us a new concept: removing lesions and functional reconstruction are both important; preventing complications and improving the patient’s quality of life are both important. Disease is indeed hateful, but in most cases, it is difficult to destroy all the structures of our middle ear. Through microsurgery, the surgeon can remove the middle ear lesions more thoroughly and rebuild a new tympanic chamber by shaping and reconstructing the remaining tympanic membrane and auditory ossicles, or by implanting an artificial auditory ossicle (nowadays, titanium auditory ossicles are commonly used, which are lighter in mass, more biocompatible, and have a longer life span). In this way, the operative cavity will be closer to the normal structure of the human body, and hearing can usually reach the level of application (about 35 decibels), and the patient usually does not have communication difficulties; and the dry ear rate is higher. Of course, now and in the future, mastoidectomy will not exit the stage of history, the middle ear lesions are serious, not suitable for tympanoplasty patients, or mastoidectomy. Thirdly, communication is gold and understanding is jade; gold and jade complement each other. In order to make our ears healthier, doctors and patients should have more exchanges, more communication; mutual understanding, and work together to strive for a good result. 1, the choice of treatment timing. This surgery is mostly elective surgery, students had better choose vacation surgery, so as not to delay their studies; married young men and women, it is best to choose to have surgery before childbirth, so as not to interfere with childbirth; middle-aged and elderly patients had better be treated before and after the age of 60 years old, 70 years of age or older surgery will be less tolerant. Of course, if you have been diagnosed with bone ulcer type or cholesteatoma type otitis media, you should have surgery as soon as possible to avoid complications. 2. Local preparation of the “pus-filled ear”. Prof. Brackmann (USA), a renowned ear surgeon, recommends that obtaining a “dry ear” before surgery is the most important condition for the treatment of chronic otitis media. With a thorough evaluation and careful treatment, most “wet ears” can achieve a “dry ear” in the preoperative phase. To achieve this, a number of measures are necessary, such as careful and repeated cleaning of the middle ear as well as the external auditory canal, topical antibiotic treatment, and the creation of an environment that is inhospitable to bacterial and fungal growth. In some cases, especially when cholesteatoma exists, it is difficult to achieve “dry ear” by any preoperative measures, and then “dry ear” becomes the purpose of surgery. 3. Choice of surgical method. The basic surgical methods have been explained earlier, which can be divided into tympanoplasty, mastoidectomy, complete tympanoplasty and open tympanoplasty, one-stage surgery or two-stage surgery, each type of surgery has its own indications and advantages and disadvantages, and the doctor and the patient should communicate with each other more often to choose a surgical method that is suitable for the patient’s condition. 4.Necessary psychological preparation, reasonable expectations. Diseases are indeed hateful, not only bring us physical suffering, but also bring us many risks of surgery. On the one hand, modified mastoidectomy with tympanoplasty, compared with the traditional mastoidectomy, has the task of removing the lesion and reconstructing the function, which is more technical, more difficult and naturally more risky. At the same time, no matter how skillful the doctor is, the treatment of the disease can not reach 100% success. At present, the success rate of tympanoplasty reaches 90%, and the dry ear rate of mastoidectomy reaches 95%, which is already a very good level; once this small probability of failure falls on oneself, one should have the necessary psychological preparation. On the other hand, there are many important structures in the middle ear: such as the facial nerve, the semicircular canals, the cochlea, the sigmoid sinus, and the cerebral plate. Surgery itself is a kind of trauma, due to the development of the disease itself as well as the stimulation of the surgery, it will face the risk of facial paralysis, tinnitus and deafness, vertigo, infection, postoperative recurrence, etc.; at the same time, there is an unpredictability in the development of any disease, and the presence of other comorbidities in the human body can have an impact on the ear disease. Therefore, it is difficult for a doctor to make a specific commitment to a specific patient, and can only state a probability. This is where communication and understanding between doctor and patient is necessary.