Comparative Outcomes of Tympanoplasty in Patients with Eustachian Tube Dilation vs. Without Eustachian Tube Dilation Using Saccharine test for Diagnosing Eustachian Tube Dysfunction: A Randomised Control Trial

Tympanoplasty is a surgical procedure done for repairing of perforated tympanic membrane i.e eardrum along with repair of middle ear structures, eustachian tube dysfunction is a common condition which affects the capacity of middle ear to regulate air pressure and drain fluids collected in middle ear which leads to persistent ear problems and compromising the outcome of ear surgeries including tympanoplasty , the Eustachian tube plays a major role in regulating the pressure within the middle ear., failure to mark eustachian tube dysfunction may cause recurrent ear infections, middle ear effusions, and unfavourable outcomes post tympanoplasty. Recent innovations like eustachian tube dilation aims to address the dysfunction by improving its function which can be done preoperatively or intraoperatively. In this study we explore the effectiveness of intraoperative eustachian tube dilation using saccharine as guide to assess eustachian tube dysfunction preoperatively. The saccharine test involves instillation of saccharine pellet through perforated tympanic membrane and monitoring its detection in the throat after passage through eustachian tube. Objective is to find out whether intraoperative eustachian tube dilation improves surgical outcome for tympanoplasty compared to those who do not undergo eustachian tube dilation? The hypothesis is that eustachian tube dilation using balloon technique and using saccharine as guide will result in significant better surgical outcomes for tympanoplasty, with better graft uptake and better hearing improvement compared to patients who do not undergo dilation.Tympanoplasty is a surgical procedure done for repairing of perforated tympanic membrane i.e eardrum along with repair of middle ear structures, eustachian tube dysfunction is a common

condition which affects the capacity of middle ear to regulate air pressure and drain fluids collected in middle ear which leads to persistent ear problems and compromising the outcome of ear surgeries including tympanoplasty , the Eustachian tube plays a major role in regulating the pressure within the middle ear., failure to mark eustachian tube dysfunction may cause recurrent ear infections, middle ear effusions, and unfavourable outcomes post tympanoplasty. Recent innovations like eustachian tube dilation aims to address the dysfunction by improving its function which can be done preoperatively or intraoperatively. In this study we explore the effectiveness of intraoperative eustachian tube dilation using saccharine as guide to assess eustachian tube dysfunction preoperatively. The saccharine test involves instillation of saccharine pellet through perforated tympanic membrane and monitoring its detection in the throat after passage through eustachian tube. Objective is to find out whether intraoperative eustachian tube dilation improves surgical outcome for tympanoplasty compared to those who do not undergo eustachian tube dilation? The hypothesis is that eustachian tube dilation using balloon technique and using saccharine as guide will result in significant better surgical

outcomes for tympanoplasty, with better graft uptake and better hearing improvement compared to patients who do not undergo dilation.