Learning Objectives: Middle ear adenomas are rare benign tumours. Surgery remains the mainstay of treatment. Longterm follow up should be carried out. Middle ear adenoma should be included in the differential diagnosis of middle ear mass in patients with persisting, non-specific symptoms.

Introduction: Middle ear adenoma is a low-grade neoplasm with the potential for recurrence and metastases. Clinical and radiological findings can be misleading and often fail to provide the right diagnosis. Our objective is to present our experience over a 10 year period.

Methods: A retrospective review of all middle ear pathology at our tertiary referral centre with a catchment area of over three million over the last 10 years was carried out.

Results: In total, only three patients were identified (prevalence 1:1,000,000), two male one female. Common symptoms of presentation included conductive hearing loss, aural pressure and autophony. Detailed imaging (computed tomography, magnetic resonance imaging complimented by angiography) was employed to better characterize the lesion and help with surgical planning. All patients underwent middle ear/ lateral skull base surgery. One patient had revision surgery for recurrence. Because of the neuroendocrine nature of ME adenomas, all patients remain under postoperative surveillance.

Conclusion: Our experience is similar to published literature. Adenomas of middle ear are indistinguishable benign tumours; surgical excision should be carried out to ensure complete excision.