Recurrent severe secondary haemorrhage due to facial artery pseudoaneurysm following styloidectomy via tonsillectomy approach: A case report.

A 41-year-old female who underwent right-sided styloidectomy via tonsillectomy approach experienced refractory short-lasting severe secondary haemorrhage on the third, seventh and thirteen postoperative days. On examination under general anaesthesia, no major vessel injury was noticed. Contrast-enhanced computerized tomography scan of the neck was done because no obvious bleeder was seen and refractory nature of bleeding. Contrast-enhanced computerized tomography scan neck showed pseudoaneurysm of facial artery which was managed with endovascular embolization successfully.

Horner's syndrome in thyroidectomy patient: Case report.

A 30-year-old female patient with no previous chronic illness underwent hemithyroidectomy unusually complaint of ptosis on first postoperative day. On examination, she also had miosis. Thus, diagnosis of Horner's syndrome was made on ground of ruling out other complication. As it is caused by nerve insult, with a prolonged observation under close follow-up, the patient is fully recovered. Horner's syndrome after thyroidectomy is a rare entity. In textbook also, it is not mentioned as complication after thyroidectomy.

Unusual presentation of tubercular mastoid cyst.

Tuberculosis in the otomastoid compartment is extremely rare. The classical presentation of tuberculous otitis media includes chronic otorrhea, severe hearing loss irrespective of the disease, multiple perforations, and pale granulations in the middle ear cavity. However, most present with non-specific signs and symptoms making it a diagnostic dilemma. Here, we report a case that presented with a bony mastoid cyst which is the first case report to the best of our knowledge. A 12-year-old boy visited our center with a complaint of chronic ear discharge and hearing loss not improving with conventional antibiotic therapy. The computed tomography scan of the temporal bone revealed soft tissue opacification in the mastoid along with features suggestive of cholesteatomatous chronic otitis media. The patient underwent mastoidectomy under general anesthesia, which revealed a bony mastoid cyst filled with turbid fluid along with granulation tissues in the middle ear cleft without cholesteatoma. Final histopathology revealed tuberculous otitis media. Antitubercular chemotherapy was started and the patient's condition recovered. Primary tuberculous mastoiditis is a rare clinical entity that requires a high index of suspicion. It can also present as chronic otorrhea with mastoid cyst, and thus need to be considered as one of the differential diagnoses.