Cinamon U et al. – This article evaluated the status of middle ear in patients with severely reduced eustachian tubes (ET) opening abilities and expected to find middle ear disorders in most of them. In conclusion, although a dysfunctional ET predisposed ME disorders, around 50% of the ears were normal as opposed to the current paradigm. This indicates that pressure homeostasis in ME is maintained by factors that can compensate for dysfunction of ET. Hence, treatment of cerumen impaction and ottis media with effusion (OME) may be advantageous for rehabilitation.