ObjectiveTo investigate the efficacy of Eustachian tube balloon dilation administered simultaneously with modified intact canal wall mastoidectomytympanoplasty in patients with middle ear cholesteatoma and Eustachian tube dysfunction.MethodsData were collected from 64 patients (64 ears) with middle ear cholesteatoma and Eustachian tube dysfunction confirmed by positive and negative pressure balance test, Dripping of tympanum,Valsalva’s level of difficulty and thin temporal bone CT scan. The 64 patients were randomly divided to control group (n=36) and observation group (n=28). Modified intact canal wall mastoidectomytympanoplasty was adopted in the control group, and Eustachian tube balloon dilation was administered simultaneously with modified intact canal wall mastoidectomytympanoplasty in the observation group. Eustachian tube dysfunction questionnaire (ETDQ7), dry ear time, pure tone audiometry and tympanogram were performed preand postoperatively. The therapeutic effect between the two groups was compared.ResultsSuccessful operation was achieved in all the patients, and the patients were followed up for 6 months to 1 year postoperatively. Before operation, the differences in the data of ETDQ7, Valsalva’s score, tympanogram and pure tone audiometry between the control group and the observation group were statistically insignificant (all P>0.05). At 6 months after operation, ETDQ7 and pure tone audiometry threshold were obviously reduced in both groups, while the differences in the data of ETDQ7, tympanogram, pure tone audiometry, involution of tympanic membrane and dry ear time between the two groups were statistically significant (all P<0.05).ConclusionEustachian tube dysfunction is an important factor in middle ear cholesteatoma. Followup results of this small sample indicate that modified intact canal wall mastoidectomytympanoplasty combined with Eustachian tube balloon dilation may yield good shortterm effect on patients with middle ear cholesteatoma and Eustachian tube dysfunction. However, the longterm efficacy remains to be further observed via large sample studies.