Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

A Systematic Review of Eustachian Tube Dysfunction in Patients Undergoing Septoplasty: Pre-operative Prevalence and Post-operative Outcomes

Document Type : Systematic Review

Author
Suhaima Pulimoottilparambil Saifuddeen
Department of Ent Head and Neck Surgery, All India Institute of Medical Sciences, Patna, Bihar, 801507.
10.22038/ijorl.2026.92326.4073
Abstract
Introduction
The relationship between septoplasty and Eustachian tube dysfunction (ETD) remains controversial despite theoretical links between nasal anatomy and middle ear physiology.
Materials and Methods
 Following PRISMA guidelines, we searched PubMed, Scopus, Web of Science, CENTRAL, and Embase up to October 2025 for studies examining ETD in septoplasty candidates. Twenty-eight studies (20 prospective cohorts, 5 retrospective cohorts, 3 RCTs; N≈2,150) met inclusion criteria.
Results: 
Pre-operative ETD prevalence was high: 38-62% by ETDQ-7 questionnaire and 35-65% by tympanometry. Septoplasty significantly improved both subjective symptoms and objective middle ear function, with peak benefits at 3-6 months. Aural fullness showed the most notable improvement. Greater pre-operative ETD severity and posterior septal deviation were associated with more substantial improvement. Transient post-operative worsening occurred in some patients but resolved spontaneously.
Conclusions: 
ETD is a frequent comorbidity in symptomatic deviated nasal septum patients. Septoplasty appears effective for concomitant ETD, supporting routine pre-operative ETD assessment and patient counseling about potential otological benefits. Evidence is moderate-level due to observational study dominance and heterogeneity.
Keywords
Septoplasty
Deviated Nasal Septum
Eustachian Tube Dysfunction
ETDQ-7
Tympanometry
Middle Ear Pressure
Nasal Obstruction
Otology
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 38, Issue 3
May and June 2026
Pages 149-158