Surgical intervention is recommended for chronic middle ear infection when conservative methods (medication) are insufficient. Surgical treatment varies depending on the extent and type of the disease.

In simple cases, particularly in patients with a perforated eardrum and no additional pathologies, eardrum repair (Tympanoplasty) is performed. These operations are usually carried out under an ear microscope, typically through a small incision made behind the ear or from the upper front part of the auricle.

In cases where the disease has progressed and affects the middle ear bone structures, surgical treatment is extended to cover these areas as well.

Cholesteatoma is a special and serious form of chronic middle ear infection, requiring urgent treatment. Cholesteatoma is defined as an abnormally growing skin accumulation in the middle ear that damages surrounding tissues. As it grows, it can lead to severe complications ranging from facial paralysis to brain abscesses. Therefore, in cases diagnosed with cholesteatoma, surgical removal of the diseased tissues and subsequent rehabilitation should be initiated without delay to halt the disease's progression and prevent potential complications.