The IOL + AOM/DSS group showed lower expression levels of NF-κB p65, IL-6, TNFα, iNOS, COX-2, and IL-1β than the IC + AOM/DSS group, whereas the ID + AOM/DSS group showed no changes in p65, IL-6, TNFα, and iNOS levels, and higher increases in COX-2 and IL-1β levels (Figure 4). Here, TNF is linked to infectious otitis media.