Highlights First branchial cleft fistula are rare and can be in form of cyst or fistula. Clinically, they may masquerade as parotid tumours or as otitis with ear drainage. Its management is surgical excision keeping the tract cyst of the fistula intact. Superficial parotidectomy with facial nerve dissection is the key to complete excision of the cleft fistula with preservation of the facial nerve.

Highlights Glomangiopericytomas, which arises in the nasal cavity and may extend into the paranasal sinuses, is categorized as a borderline low malignancy tumor by the WHO classification. Complete transnasal endoscopic excision is the optimal treatment. A regular postoperative follow-up is recommended for early finding of tumor recurrence.

Highlights Ethmoidal fibrosarcoma is an extremely rare tumor. Mostly misdiagnosed because of none specifics symptoms, in this case patient didn’t complaint any nasal symptom. Treatment is not codified and prognosis is unknown.

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Introduction—Although auditory brainstem response (ABR) testing is among the most frequently used investigations in pediatric audiology and it often requires sedation or general anesthesia. In recent years, melatonin has been successfully used as an alternative way of inducing sleep, particularly in children undergoing magnetic resonance imaging (MRI) or electroencephalography (EEG). Purpose—To assess the effectiveness of orally administered melatonin as an alternative to sedation or general anesthesia during ABR testing. Method—In total, 33 children with suspected hearing loss underwent ABR tests in melatonin-induced sleep. Each patient received an initial dose of 5 mg, which was re-administered in case of failure to obtain sleep. Click-induced ABR tests were performed on both ears. Results—ABR tests were successfully performed in 72.7% of the patients. The average total length of time needed to obtain sleep and complete the ABR testing was 45 min. There was no significant difference between the patients who completed the examination and those who did not in terms of age or psychomotor development. There was a statistically significant association between receiving a maintenance dose and successful completion of the test (p < 0.001). There was also a significant connection between the degree of hearing loss and the success rate of the ABR tests (p < 0.001). Conclusions—Melatonin-induced sleep is a good and safer alternative to anesthesia to perform ABR testing in young children. It is easily administered, tolerated by the patients, and accepted by parents.

Giant lipoma is a rare cause of a large painless neck mass, these lipomas are usually found on the extremity, but rarely occur in the head and neck, computed tomography (CT) scan is very suitable for the diagnosis, Surgical excision is the best treatment. We describe a case of a man with a massive lipoma of the left neck, histological finding confirmed the diagnosis of spindle-cell lipoma, well managed with surgical excision.

Thyroid Tuberculosis is difficult to diagnose, thus Fine Needle Aspiration Cytology (FNAC) or histopathological examination of the resected specimen forms the mainstay of diagnosis [2].We report a very rare case of thyroid localization of primary tuberculosis revealed by a mediastinitis. This case highlights the importance of evoking the diagnosis of tuberculosis in case of any anterior abscess of the neck with an insidious clinical presentation.

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