Otitis media can cause enlargement of lymph nodes, especially in acute suppurative otitis media. There are many lymphatic tissues and lymphoid follicles in the head and neck, and the most common lymph nodes are those in the ectolymphatic ring, which are located in front of the ear, behind the ear, on the surface of the mastoid process, near the angle of the lower jaw and around the parotid gland. When there is acute inflammation of the upper respiratory tract or surrounding tissues and organs, the lymph nodes to which they belong may become enlarged repeatedly due to the acute inflammation, and chronic lymph node enlargement may develop after repeated infections. Otitis media, especially acute suppurative otitis media and acute secretory otitis media, can cause enlargement of lymph nodes, usually around the ear, on the surface of the mastoid, and in the vicinity of the angle of the lower jaw.