Ostmann’s Fat Pad—Does it Really Matter?

Objective: To compare the size of Ostmann’s fat pad (OFP) between healthy ears and ears with chronic otitis media with cholestatoma (COMwC) using magnetic resonance imaging (MRI). Methods: Twenty-six patients with unilateral COMwC underwent mastoidectomy. Pre-operative MRI records were reviewed retrospectively. The healthy ears served as the control group. OFP is represented by the maximum diameter of the high intensity area medial to the tensor veli palatini muscle (TVP); M1. A reference diameter was defined from the medial border of OFP reaching the medial border of the medial pterygoid muscle; M2. Values of M1, M2 and the ratio of M1:M2 was compared between the healthy and pathological ear in each patient. Results: All 26 patients (16 females,10 males) had unilateral cholestatoma. Mean age was 37.6 years (range 19-83). In the healthy (_H) ears group, mean M1_H was 2.04 ± 0.53 mm, mean M2_H was 9.57 ± 2.57 mm. In the pathological (_P) ears group; mean M1_P was 2.03 ± 0.55 mm, mean M2_P was 9.86 ± 2.37 mm. A comparison of M1 and M2 values between the healthy and pathological ear groups was not statistically significant (P =.853 and P =.509, respectively). Mean M1_H:M2_H ratio in the healthy ears group was 0.22 ± 0.05, mean M1_P:M2_P ratio in the pathological ear group was 0.21 ± 0.06. A comparison between these ratios found no significant statistical correlation (P =.607). Conclusion: The size of Ostmann’s fat pad does not affect the development of chronic otitis media with cholestatoma in adults.