Background: Nasal packs are frequently used after nasal surgery for hemostasis and internal stabilization of bony and cartilaginous structures. Nasal packing causes lymphatic stasis in nasopharynx and around the opening of Eustachian Tube, which ultimately results in middle ear dysfunction. Objectives: The aim of this study is to compare the effect on Middle Ear Pressure and Hearing Threshold of Anterior Nasal Packing using Merocel Pack and Merocel Pack with Sialistic Tube. Methods: This is a non–randomised comparative interventional study which was carried out in the Department of Otorhinolaryngology – Head & Neck surgery, Dr. Vasantrao Pawar Medical College for the period of two years from February 2017 to October 2018. 66 patients were selected. Results: 66 patients were studied. Out of 66 patients two groups were compared one with Merocel Pack with Tube and Merocel Pack without Tube. Statistically significant difference observed between pre and post operative middle ear pressure of patients of Merocel Pack with and without Tube. Out of 33 post operative patients of Merocel Pack without tube had mean middle ear pressure –61.12±23.56daPa and –58.4±29.23daPa for Right and Left Ear respectively. Whereas out of 33 post operative patients of Merocel Pack with Tube had –49.72±27.2daPa and –43.48±26.26daPa for Right and Left ear. Statistically significant difference observed between them for post operative patients of Merocel Pack with or without Tube for both Right and Left ear. Conclusion: There is post operatively increase in middle ear pressure transiently for few days with nasal pack in situ which returns to normal after pack removal. In this comparative study, middle ear pressure was found to be more negative in patients using Merocel Pack without tube as there was complete blockage of the nostrils of the patients. However, in Merocel Pack with Tube patients patient was able to breathe by nose through ventilating tube so middle ear pressure did not increase as that of without Tube patients. Also, patient felt symptomatically better with the Tube packing because of no mouth breathing post operatively.