We found that re-expression of Nrf2 in OME-macrophages at day 7 significantly reduced inflammatory cells in OME (Figures 6A, C), increased M2 polarization of macrophages (Figures 6A, D), reduced the levels of IL-1β, IL-6, TNFα, and IFNɣ in OME (Figures 6E–H), reduced the levels of ROS and MDA (Figures 6I, J), and increased the levels of SOD and GSH (Figures 6K, L) in the middle ear mucosae tissue at 4 weeks. Here, TNF is linked to otitis media with effusion.