Learning Objectives: After this presentation, the attendee will understand the effects of smoking on Eustachian tube dysfunction and its impact on chronic ear disease. They will understand how smoking increases the severity of cholesteatoma and how smoking leads to more extensive surgery.

Smoking is a known to be a risk factor for cardiac disease, chronic obstructive lung disease, head and neck cancer and lung cancer. Cessation of smoking will reduce a person's risk for cardiac and lung disease over time, but will not reduce it back to the risk level of life long non-smokers. Cigarette smoking is also known to worsen outcomes in plastic surgery and sinus surgery. Smoking has multiple deleterious effects on ciliary function, some of which are reversible and some of which are permanent. We will exame, in depth, the effects of cigarette smoking on the severity of chronic ear disease and its effects on surgical outcomes for chronic ear disease.

This talk will describe the effects of cigarette smoking on ciliary function and Eustachian tube function. We will then discuss a large series of patients who underwent surgery for tympanic membrane perforation with or without cholesteatoma and analyze their surgical outcomes with regards to their smoking status. We will show how short term and long-term abstinence from cigarettes smoking effects their surgical outcomes compared to life long non-smokers.