Concurrent balloon eustachian tuboplasty and type I tympanoplasty in chronic otitis media with eustachian tube dysfunction: a propensity score-matched cohort study

Background Eustachian tube dysfunction (ETD) may impair graft outcomes after type I tympanoplasty in chronic suppurative otitis media (CSOM).Objective To compare concurrent balloon Eustachian tuboplasty (BET) plus tympanoplasty with tympanoplasty alone in CSOM with ETD.Materials and Methods This retrospective propensity score-matched cohort included CSOM patients with ETD treated from May 2021 to April 2024. The primary endpoint was 24-month tympanic membrane integrity; secondary endpoints were air-bone gap (ABG) closure, ETDQ-7, tubo-manometry, and complications.Results Sixty matched pairs were analyzed. At 24 months, graft integrity was higher with BET plus tympanoplasty than with tympanoplasty alone (57/60, 95.0% vs. 49/60, 81.7%); BET was associated with lower graft-failure hazard (HR 0.28, 95% CI 0.11–0.74; p = 0.024). The combined group also had greater ABG closure (10.3 ± 3.4 vs. 5.4 ± 3.8 dB), lower ETDQ-7 scores (11.2 ± 2.4 vs. 15.8 ± 3.5), and more frequent TMM normalization (86.7% vs. 58.3%) (all p < 0.001). No severe complications occurred.Conclusion Concurrent BET was associated with better long-term graft, hearing, and ETD-related outcomes.