Abstract： To the Editor:Otitis media with effusion (OME),also known as secretory otitis,is a disease in which secreted fluid accumulates in the middle ear cavity and is a major cause of hearing loss,both in children and adults.[1] Causes of OME include recurrent infections,inflammatory conditions,malformations,and eustachian tube dysfunctions.[2]Although most patients could recover spontaneously,by medication,or by surgery,some patients show frequent recurrence of otitis media for more than 3 months,called chronic otitis media with effusion (COME).[1] The pathogenesis of COME is not completely understood.Increasing evidence suggests a central role of immunologic cells and their associated cytokines in the chronic inflammation that characterizes COME.