Many patients like to explain the pathogenesis of otitis media in this way, but it should be said that this explanation is not entirely correct. First of all, the systemic and local causes of otitis media have already been discussed, which do include a decrease in the body’s defense function. In other words, these systemic factors are the conditions under which the etiology occurs, and there is a primary and secondary role for the etiology and the causative factors in the pathogenesis. For example, in the case of suppurative otitis media, if there is no pathogen, even if the body is fatigued or immune system is low, it is not easy to develop the disease, while physical fatigue and immune system low can be substituted for each other as the causative factors of otitis media, but the role of the pathogen is irreplaceable. In fact, if you think about it this way, you should understand better that fatigue and immune deficiency should affect both sides at the same time, while the onset of various otitis media is mostly unilateral. Secondly, fatigue and immune deficiency can be put on as causative factors for many diseases, and if one is satisfied with this rather general and superficial explanation, it is not much of a guide for subsequent treatment, as after all, most otitis media cannot be cured by rest or immune system enhancement alone. Finally, in many cases, immune problems are not necessarily low, but may be disordered or hyperactive. For example, some otitis media may be related to allergic reactions, or allergic reactions, in the nasal cavity or middle ear, which cannot simply be interpreted as a low immune system, with an emphasis on boosting the immune system, when in fact these allergic reactions may be more appropriately understood as a hyperactive state of some aspect of the immune system.