Abstract Objective This study aimed to compare the effect of pneumatised and non-pneumatised mastoid on the success of tympanoplasty in terms of rate of graft uptake and air–bone gap improvement.Method A comprehensive electronic search of PubMed Medline, Scopus, Web of Science and Cochrane Library was conducted in August 2020 for articles from 1990 to 2020. Selected studies were published in the English language, were conducted on human patients, were concerned with evaluating pre-operative mastoid pneumatisation on tympanoplasty success, were not laboratory studies and were not opinion studies. Five studies were included with 178 patients in the pneumatised group and 97 patients were included in the non-pneumatised group. Comparison between both groups was performed in terms of graft uptake rate and air–bone gap improvement.Results Although the pneumatised group showed better graft uptake rate than the non-pneumatised group, there was no statistically significant difference between the two groups in the success rate of tympanoplasty.Conclusion Pneumatisation of the mastoid does not significantly affect the success rate of tympanoplasty.
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