OBJECTIVE： To observe the efficacy and safety of different administration of dexamethasone in the treatment of secretory otitis media. METHODS： Data of 92 patients with secretory otitis media was retrospectively collected and divided into observation group （43 cases） and control group （49 cases） by different administration. Observation group received 5 mg Dexamethasone injection by injection in the eustachian tube in the assisted by video laryngoscope， once every 2 day. Control group received 5 mg Dexamethasone injection by injection in the eustachian tube， once every 2 day. 7-day was regarded as 1 treatment course. 1 more course for uncured patients， and no more than 4 courses. Clinical efficacy， and tumor necrosis factor-α（TNF-α）， C-reactive protein （CRP）， interleukin-6（IL-6），IL-10 levels before and after treatment， and 1-year cumulative recurrence rate after cured and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in observation group was significantly higher than control group， 1-year cumulative recurrence rate after cured was significantly lower than control group， the differences were statistically significant （P＜0.05）. Before treatment， there were no significant differences in TNF-α， CRP， IL-6 and IL-10 levels between 2 groups （P＞0.05）. After treatment， TNF-α and IL-6 level in 2 groups were significantly lower than before， and observation group was lower than control group， the differences were statistically significant （P＜0.05）； there were no significant differences in CRP and IL-10 between 2 groups before and after treatment （P＞0.05）. And there was no significant difference in the incidence of adverse reactions between 2 groups （P＞0.05）. CONCLUSIONS： The efficacy of dexamethasone by injection in the eustachian tube in the assisted by electron-nasopharyngolaryngoscopy is superior to auripuncture administration， it can reduce recurrence rate， with good safety.