Abstract: Objective: Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation,we evaluate its efficacy in the threatment of adult refractory otitis media with effusion.Method: We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013.According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears).In the control group,the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions.The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively)to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively)objectively.Result: In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65%(13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3%(5/35) in 1 year.The difference was statistically significant (P<0.01). There were similar hearing improvement in the two groups after treatment in 1 month, but the hearing improvement in the treatment group increased with time. There were no complications occuring during the operation and post-operation. Within a month after operation, the majority of ears(28/35) obtained significant hearing improvement with the decreasing air-bone-gap comparision with the pre-operation (P<0.01), and the preoperative tympanogram of 16 ears with type B or C turned to type A (P<0.01). There were no both statistical significane in the variation of air-bone-gap and tympanogram of comparision with the results between three months and six months,six months and one year postoperatively (P>0.05).Conclusion: This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.