Introduction: It was proposed that the tympanostomy tube be incorporated in the cartilage graft. Moreover, they proposed that this marriage, when used to reverse atelectasis and to repneumatize the middle ear, should offer the advantage of both procedures while reducing the incidence of tube extrusion and other complications of prolonged intubation.Objectives: The aim of this work is to detect the efficacy of combined T-tube cartilage tympanoplasty in a patient population prone to atelectasis and to compare it with cartilage tympanoplasty.Materials and Methods: This is a randomized prospective study. Twenty patients with TM atelectasis and / or retraction pocket and intact ossicular chain were included in the study. They were randomly assigned into 2 groups: Group I included 10 patients who underwent reconstruction of the TM using the perichondrium/cartilage graft, performed with concomitant intraoperative T-tube insertion; and Group II included 10 patients who underwent reconstruction of the TM using the perichondrium/cartilage graft without ventilation tube insertion.Results: significant postoperative improvement of pure-tone air-conduction threshold averages and ABG averages were reported in the 2 studied groups. The grafts were taken and the TM had returned from a collapsed state to near normal in all patients.Conclusions: There is no significant difference in the improvement of cases that need prolonged middle ear ventilation either treated with cartilage shield T-tube tympanoplasty or cartilage tympanoplasy alone.