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Review
. 2025 Oct;282(10):5005-5021.
doi: 10.1007/s00405-025-09411-y. Epub 2025 Apr 30.

Outcomes of combined tympanoplasty and eustachian tuboplasty versus tympanoplasty alone: A systematic review and meta-analysis

Mohammed A Al-Hamoud  1 , Mona A AlShehri  2 , Azza M Al-Marir  2 , Aishah S Alshahrani  2 , Majed Assiri  3 , Fares E ALGhamdi  4
Affiliations
Review

Outcomes of combined tympanoplasty and eustachian tuboplasty versus tympanoplasty alone: A systematic review and meta-analysis

Mohammed A Al-Hamoud et al. Eur Arch Otorhinolaryngol. 2025 Oct.

Abstract

Purpose: Eustachian tube dysfunction plays a crucial role in the pathophysiology of chronic otitis media and impacts surgical outcomes of tympanoplasty. We aimed to assess the outcomes of combined tympanoplasty with eustachian tuboplasty compared to tympanoplasty alone with respect totes graft success rate, hearing outcome, tympanometry measures, and improvement of eustachian tube function.

Methods: This review has been registered in the Prospective Register of Systematic Reviews. (CRD42024614970) and was conducted according to the PRISMA guidelines. Four major databases-PubMed, ScienceDirect, Web of Science, and Google Scholar-were used for the electronic search to identify relevant studies.

Results: Seven studies involving 386 patients were included; 195 (50.5%) and 191 patients (49.5%) were assigned to the tympanoplasty plus eustachian tuboplasty and tympanoplasty alone groups, respectively. The meta-analysis revealed significant improvements in graft success rates (Odds Ratio = 1.90, 95% CI: 1.02 to 3.54, p = 0.042), air-bone gap (MD = -2.07, 95% CI: -3.78 to -0.36, p = 0.018), and eustachian tube scores (Mean difference = 2.00, 95% CI: 0.02 to 3.98, p = 0.048) in the combined group compared to in the control group. Only minor complications were observed in some studies, such as mild tympanic membrane retraction, graft myringitis, and temporary patulous eustachian tubes.

Conclusion: Combining tuboplasty with tympanoplasty is an effective procedure with significant improvements in graft success rates, hearing outcomes, and eustachian tube function scores. Eustachian tuboplasty is a safe and successful procedure with very few potential complications.

Keywords: Chronic otitis media; Eustachian tube dysfunction; Eustachian tuboplasty; Tympanoplasty.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: No ethical approval required for this systematic review and meta-analysis. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose.

References

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