Introduction  Neuroendocrine adenomas of the middle ear (NAME) are uncommon causes of middle ear masses. Mostly limited to case reports and small series, the literature is poor in providing an overall assessment of these tumors. Objective  To review the current literature about all aspects of the disease, including its etiology, clinical manifestations, diagnosis, and treatment. Data Synthesis  The pathogenesis of adenomatous tumors of the middle ear is not clear yet. One potential explanation is that an undifferentiated pluripotent endodermal stem cell may still be present in the middle ear mucosal surface, and may be the origin of the tumors. It typically appears as a nonspecific retrotympanic mass. The average age of onset for the disease is the fifth decade, and the most common clinical symptom is conductive hearing loss. Malign behavior is rare. There are numerous differential diagnoses of NAME. The final diagnosis depends on microscopic findings. The preoperative evaluation should include the use of computed tomography and magnetic resonance imaging. The adjunctive therapy of middle ear adenomatous tumors with radiotherapy, chemotherapy or somatostatin analogs is generally not recommended. Conclusion  There is still much debate on pathogenesis and classification of NAME. Saliba's classification is currently the most complete and preferable one. Aggressive surgical procedure with ossicular chain excision is the gold standard treatment. Follow-up with physical and radiological exams is mandatory, particularly if the first procedure was conservative, without the removal of the encased ossicles.

Objective: The objective of this study was to identify factors associated with mesh erosion after placement of a transobturator sling for correction of stress urinary incontinence (SUI). Design: Between 2006 and 2008, a consecutive series of patients underwent surgery for SUI. A retrospective analysis was performed and included baseline, surgical, postoperative, and complication data. Materials and Methods: A total of 69 patients underwent surgery for SUI by placement of a polypropylene mesh sling using the transobturator approach. Demographic and medical history data were collected by interview at baseline, 1 month, 6 months, and 1 year after the procedure. A speculum examination to screen for mesh erosion and infection was performed at each postoperative visit. Comparisons between groups were performed using a v 2 and unpaired Student's t-test. The level of significance was set at p < 0.05. Results: There were 5 (7.2%) mesh erosions reported within 1 year of surgery. Forty-two (60.9%) patients had concomitant surgeries. Age, parity, menopause status, hormonal therapy, body mass index, diabetes mellitus, vaginal trophism, previous and concomitant surgery, and perioperative complications were not associated with mesh erosion. Univariate analysis only identified previous surgery for SUI (3.6 versus 33.3%; p = 0.002) and perioperative inadvertent vaginal transfixation (4.5 versus 66.7%; p < 0.001) as significant factors associated with vaginal erosion. Conclusions: Previous surgery for SUI, and perioperative inadvertent vaginal transfixation, are risk factors for vaginal mesh erosion after transobturator sling placement. ( J GYNECOL SURG 29:231)

Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article.