There are two types of otitis media, one is a direct consequence of bacterial infection and is called purulent otitis media, which is classified as acute or chronic. Chronic purulent otitis media is further divided into 3 types, simple, osteochondritic, and cholesteatomatous. The other type, which is not directly related to bacterial infection but to pharyngeal tube opacification, is called secretory otitis media. However, all chronic suppurative otitis media should be treated surgically, either by tympanic membrane repair, or by repairing the tympanic membrane and reconstructing the auditory tuberosity on the basis of clearing the lesion, or by clearing the lesion without repairing it; only the surgical methods are different and the timing of surgery needs to be grasped. It is internationally accepted that secretory otitis media is the first cause of deafness in children, so parents must pay attention to it. If left untreated for a long time, it may lead to adhesions in the middle ear tympanic chamber, or cause the tympanic membrane to become invaginated and become cholesteatoma-type otitis media, or even appear in early childhood, with severe deafness and impaired language development, the so-called ten deafness and nine mute. If adults develop secretory otitis media, most of them have primary causes, such as rhinosinusitis and nasopharyngeal neoplasia, which may require treatment of the primary cause. I often struggle to explain such doubts when I receive consultations, so I write some words for patients’ reference, which are my personal views and do not represent authoritative opinions.