〔Abstract〕 Objective To investigate the effect and complications of tympanotomy tube insertion (TTI) combined with intratympanic injection of dexamethasone in the treatment of secretory otitis media. Methods A total of 86 patients with secretory otitis media treated in the department of otolaryngology, Zhengzhou Seventh People's Hospital from October 2019 to August 2021 were selected as the research subjects, and they were divided into an observation group and a control group according to random number table method, with 43 cases in each group. The control group was treated with TTI, and the observation group was treated with TTI combined with intra-tympanic injection of dexamethasone. The treatment efficacy was evaluated by comparing the tympanogram, air conduction and bone conduction valve of patients in the two groups before, 1 week and 2 weeks after surgery. The severity of tinnitus (tinnitus consultation and evaluation table) and the incidence of complications (infection, posterior perforation and otorrhea) in the two groups were compared 2 weeks after surgery. Results Compared with before surgery, 1 week after surgery, the proportion of type A patients in the observation group was significantly increased, and the difference was statistically significant (P < 0.05). The bone conduction threshold of the two groups was significantly decreased, and the bone conduction threshold of the observation group was significantly lower than that in the control group, the difference was statistically significant (P < 0.05). The scores of tinnitus inquiries and assessment sheets in the two groups were significantly decreased, and the scores of tinnitus inquiries and assessment sheets of the observation group were significantly lower than those of the control group, the differences were statistically significant (P < 0.05). Two weeks after surgery, the proportion of type A patients in the two groups were significantly increased, and the number of observation group was more than that of the control group, the differences were statistically significant (P < 0.05). The threshold values of air and bone conductance in the two groups were significantly decreased, and the threshold values of air and bone conductance of the observation group was significantly lower than that of the control group, the difference was statistically significant (P < 0.05). The scores of tinnitus consultation and assessment table in the two groups were significantly decreased, and the scores of tinnitus consultation and assessment table of the observation group were significantly lower than those of the control group, the differences were statistically significant (P < 0.05); There was no significant difference in the total incidence of infection, posterior perforation, otorrhea and complications between the two groups (P > 0.05). ConclusionTTI combined with intratympanic injection of dexamethasone can improve patients' hearing and play a positive role in improving the therapeutic effect of secretory otitis media. Moreover, the addition of dexamethasone has little effect on the risk of complications.