Otitis media primarily refers to the inflammation of the tympanic membrane, tympanic cavity, and mastoid in the middle ear. Clinically, the main causes of otitis media include the following: firstly, infectious factors, which are mainly bacterial infections. Bacteria can infect the middle ear through the external auditory canal, through the Eustachian tube from the nasopharynx to the tympanic cavity of the middle ear, or via the bloodstream to the tympanic cavity, tympanic membrane, and mastoid, leading to symptoms of otitis media. These are our pathways of infection. So, what causes these infections? Or what factors might influence the occurrence of these infections, that is, the occurrence of otitis media? Key factors include decreased immunity in children, increased virulence of bacterial infections, which involves highly infectious bacteria, and our anatomical structure, namely, the imperfection or incompleteness of the middle ear structure and the anatomical connections between the ears.