Objective:To explore the influence of balloon eustachian tuboplasty(BET)combined with tympanotomy tube inser-tion(TTI)on auditory threshold and eustachian tube function in patients with refractory otitis media with effusion(OME).Methods:120 patients with refractory OME were selected as the research subjects.According to the different surgical methods,the patients were divided into TTI group(TTI+eustachian tube irrigation)and TTI+BET group(BET combined with TTI+eustachian tube irriga-tion),with 60 cases in each group.Both groups were followed up for 12 months after surgery.The clinical symptoms,complications,hearing threshold[air conduction(AC)threshold,bone conduction(BC)threshold]before surgery and at 1 month after surgery,eu-stachian tube function(ETDQ-7)and pain(VAS)before surgery and at 1,6 and 12 months after surgery and recurrence status after 1 year of follow-up were compared between the two groups.Results:The disappearance time of middle ear effusion,disappearance time of tinnitus and hearing recovery time in TTI+BET group were shorter than those in TTI group(P＜0.05).There was no statistically sig-nificant difference in the overall incidence of postoperative complications between the two groups(P＞0.05).At 1 month after surgery,AC and BC were decreased in both groups(P＜0.05),and the TTI+BET group had lower AC and BC than TTI group after treatment(P＜0.05).At 1,6 and 12 months after surgery,ETDQ-7 score and VAS score in both groups were lower than those before surgery(P＜0.05),and ETDQ-7 score and VAS score in TTI+BET group at each time period after surgery were lower than those in TTI group(P＜0.05).The recurrence rate was lower in TTI+BET group than that in TTI group(P＜0.05).Conclusion:BET combined with TTI and eustachian tube irrigation can improve the clinical efficacy,improve the eustachian tube dysfunction of refractory OME,and re-duce the hearing threshold,and it has low recurrence rate.