Objective To compare the effect of low temperature plasma ablation combined with tympanic membrane CO₂ laser perforation, low temperature plasma ablation combined with tympanic membrane tube in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS) with secretory otitis media.Methods A total of 102 children with OSAHS and secretory otitis media (152 ears) admitted to our hospital from January 2015 to June 2021 were selected as the research objects, and divided into control group (51 cases, 74 ears) and study group (51 ears) by random number table method. The control group was given low-temperature plasma ablation combined with tympanic membrane tube placement, and the study group was given low-temperature plasma ablation combined with tympanic membrane CO₂ laser perforation. The patients were followed up for 6 months after operation. Eustachian tube function was compared between the two groups before and after surgery. The clinical efficacy of the two groups at 1 month, 3 months, and 6 months after the operation was recorded. The changes of respiration and inflammatory factors before and after surgery were compared between the two groups. The incidence of postoperative complications and recurrence of the two groups were compared.Results Comparison of the tympanic tube dysfunction questionnaire-7 (ETDQ-7) scores between the study group and the control group before surgery, 1 month after surgery, 3 months after surgery, and 6 months after surgery showed that the ETDQ-7 at different time points, with significant differences (P < 0.05). There was no difference in ETDQ-7 score between the study group and the control group (P > 0.05). There was no difference in the trend of ETDQ-7 scores between the study group and the control group (P > 0.05). There was no significant difference in the total effective rate at 1 month, 3 months, and 6 months after operation between the two groups (P > 0.05). There were no significant differences in apnea hypopnea index (AHI) and lowest blood oxygen saturation (LSaO₂) between the two groups before and 6 months after surgery (P > 0.05). The differences of tumor necrosis factor -α (TNF-α), human epidermal growth factor (hEGF), and endothelin-1 (ET-1) in the study group were higher than those in the control group before and 3 months after operation (P < 0.05). The total incidence of complications in the study group was lower than that in the control group (P < 0.05). There was no significant difference in the recurrence rate between the two groups (P > 0.05).Conclusion The short-term efficacy of low-temperature plasma ablation combined with tympanic membrane CO₂ laser drilling in the treatment of OSAHS and secretory otitis media children is similar to that of low-temperature plasma ablation combined with tympanic membrane tube placement, but low-temperature plasma ablation combined with tympanic membrane CO₂ laser drilling has better safety.