The authors suggest that nasal septal deviation (NSD) or septoplasty possibly affect Eustachian tube (ET) function. They conclude this from their prospective study on 25 patients who underwent septoplasty for NSD. These patients aged above 14 years had no other known cause of Eustachian tube dysfunction. Nasal obstruction of these patients was measured using nasal obstruction symptom evaluation scale and visual analogue scale scores, and acoustic rhinometry and anterior rhinomanometry. ET function was assessed by the ETF1 test, measuring basal middle ear pressure at rest, during Toynbee and Valsalva manouvres, via tympanometry. These measurements of nasal obstruction and ET dysfunction were taken before septoplasty and at first and third postoperative months. Surgery included inferior turbinate reduction if indicated. Results were compared with a control group of 25 patients with no rhinological or otological symptoms or signs. There was a significantly higher rate of ET dysfunction in the NSD group 16/50 (32%) versus 7/50 (14%). ET function improved following septoplasty beginning in the first postoperative month and results were significant in the third postoperative month (p = 0.004). However, septoplasty could also have a temporary detrimental effect on ET function as six ETs turned dysfunctional in the first postoperative month, four of which returned to normal in the third month.