Background: Bariatric surgery, widely considered the most effective surgical treatment for obesity and its complications, carries risks and benefits, including a common issue with eustachian tube defects. This study aims to evaluate the association between weight loss following bariatric surgery and Eustachian tube dysfunction (ETD). Methods: This descriptive cross-sectional study included 256 patients who underwent bariatric surgery at a tertiary center in Riyadh, Saudi Arabia between January 2020 and December 2021. Data was obtained through the use of an online questionnaire administered via telephone interviews, which included demographic details, clinical presentation, and an Arabic-validated version of the (ETD-7) questionnaire. Participants with a past history of ear disease, symptoms, or previous ear surgery were excluded from the study. Results: In a study involving 314 initial subjects, 256 patients were included, while 58 were excluded due to various criteria, such as previous ear surgery, a history of Eustachian tube dysfunction, or missing data. The demographic analysis revealed a diverse age distribution, with the majority falling between 31 to 50 years, and a higher representation of females (63.4%) compared to males (36.6%). Most patients were non-smokers (83.7%). The BMI analysis pre- and post-bariatric surgery showed a significant reduction, with a mean pre-op BMI of 45.87 and post-op BMI of 29.41. Only 8.9% of patients experienced Eustachian tube dysfunction post-surgery, while 91.1% did not report such issues. Conclusion: Our findings suggest that sudden and severe weight loss may not be a significant cause of the development of ETD; more research with more extended follow-up periods using tubal dysfunction testing is needed to uncover the potential underlying causes of these symptoms.

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