Myringoplasty with tympanostomy tube placement may be performed for patients with a variety of middle ear conditions. Often, eustachian tube dysfunction causes otitis media, tympanic membrane perforation, or conductive hearing loss. In the present case, myringoplasty was performed using the CO2 laser, providing reorganization of collagen fibers and improved compliance of the tympanic membrane. Given the ongoing eustachian tube dysfunction, a pressure equalization tube was placed to prevent recurrent retraction and atelectasis of the ear drum.