Case report: Recurrent spontaneous cerebrospinal fluid (CSF) leak.

INTRODUCTION AND IMPORTANCE: Obese, middle age, females, and increased intracranial pressure is the commonest predisposing factors for spontaneous cerebrospinal fluid. CASE PRESENTATION: Here we present a middle-aged female presented 1 year ago with right sided CSF Leak the confirmed by Beta 2 Transferrin and CT scan and repair have been done. Now she presented with the same complains in the left side. CONCLUSION: Proper management of increased intracranial pressure must be done pre and post skull base repair to prevent recurrence either in the same side or the opposite side.

A complete second branchial fistula in a four years old child.

INTRODUCTION AND IMPORTANCE: Second branchial anomalies either cyst, sinus, or fistula are the top differential diagnosis of lateral neck masses or swelling in pediatrics age group. Yet, it is very rare for the branchial fistula to have two openings. CASE PRESENTATION: Here we present a four years old child diagnosed with complete branchial fistula by CT scan with dye injection throughout the fistula tract. We successfully managed him by complete surgical resection. Also, we provide the current literature that aids in the diagnosis and treatment of complete second branchial fistula. CONCLUSION: Complete second branchial fistula is not that common anomaly; however, we must consider it as a differential diagnosis in any lateral neck masses. Complete surgical resection, step ladder approach, which will minimise the recurrence rate is the treatment of choice.

Case report: Nasopharyngeal mucormycosis, atypical presentation in a seventy-year-old diabetic lady.

INTRODUCTION AND IMPORTANCE: Mucormycosis is rare type of infection yet, it is common in patient with Diabetes Mellitus and immune deficiencies. Mucormycosis mostly target the rhino-orbito-cerebral region, hence the common presenting symptoms are nasal symptoms followed by orbito-cerebral symptoms. CASE PRESENTATION: Here, we present a diabetic lady with unusual presentation of mucormycosis. This old lady present with long history of left dull ear pain and decrease in hearing, nasopharyngeal exam revealed a mild bulging in the fossa of Rosenmuller region. The mild bulging reported as left nasopharyngeal heterogonous soft tissue mass extending to the left external auditory canal and skull base by CT scan. Excisional biopsy was taken and found to be nasopharyngeal mucormycosis CONCLUSION: Mucormycosis is a fatal infection which require early diagnosis and emergent intervention.