<p>Chronic Otitis Media (COM), is an inflammatory condition affecting the mucoperiosteal lining of the middle ear cleft including attic, aditus, eustachian tube orifice. Type 1 Tympanoplasty is a frequently performed surgery for the treatment of chronic otitis media mucosal. Good eustachian tube function is an important factor contributing to success of tympanoplasty. This study explores the usage of dexamethasone irrigation in middle ear intraoperatively to reduce local inflammation around eustachian tube to improve postoperative outcomes. This prospective randomised control trial assessed the efficacy of intraoperative eustachian tube wash in patients undergoing type 1 tympanoplasty. 116 patients satisfying inclusion and exclusion criteria were enrolled. All patients underwent detailed examination with otoscope/ otoendoscopy and pure tone audiometry. The patients were randomised into 2 groups: Group A received intraoperative dexamethasone washes and Group B received intraoperative saline washes in the eustachian tube orifice. Follow-up included evaluation of graft uptake with otoscope/otoendoscopy at 1 month, and reassessment at 3 months along with pure tone audiometry and impedance audiometry. There was statistically significant improvement in hearing comparing preoperative and postoperative outcomes in both group A and group B. There was no statistically significant difference in graft uptake or hearing outcomes on comparing group A and group B at the end of 1 month and at the end of 3 months. Intraoperative dexamethasone irrigation is not an essential step in tympanoplasty but can still be performed according to surgeons preference.</p>