Acute otitis media and secretory otitis media are mostly caused by inflammation of the eustachian tube due to upper respiratory tract infection. At this time, the mucous membrane of the eustachian tube is congested and edematous, and its function is impaired, so that it cannot drain the fluid in the middle ear to the nasopharynx, which affects the recovery of otitis media. For this pathogenesis, nasal decongestants such as 1% ephedrine can reduce the swelling of the mucous membrane of the pharyngo-pharyngeal opening of the eustachian tube, improve middle ear drainage, and promote the early elimination of middle ear inflammation. Therefore, nasal decongestants are often used for acute otitis media, whereas for secretory otitis media, only nasal drops are used because the eardrum is not perforated and ear drops are ineffective. It should be noted that many patients feel that topical medications are not imported, so they do not pay much attention to strict sterilization and hygiene. In fact, whether it is nasal drops or ear drops, you should wash your hands before and after the drops, and the pointed part of the dropper should not touch the ear, nose and other diseased parts, nor should you share a drug with others to avoid contamination of the solution or mutual infection. Lastly, it should be noted that the continued use of nasal decongestants such as ephedrine may lead to drug rhinitis, which is characterized by a deteriorating vasoconstrictive effect of the drug. In conclusion, when using nasal decongestants in the treatment of otitis media, it is necessary to weigh the pros and cons and to consider the course of treatment, otherwise the ear disease may not recover and lead to nasal disorders.