Objectives: To present a case of cervical vagal schwannoma and describe our experience with the clinical presentation, surgical management and outcome of an elderly patient with this pathology. Methods:Design: Case Report Setting: Tertiary Public Hospital Patient: OneResults: A 65-year-old lady presented with a recently enlarging, pulsatile right sided neck mass that had been asymptomatic for 15 years. Contrast CT revealed a circumscribed non-enhancing heterogenous 4 x 4 x 7 cm mass splaying the right internal jugular vein and common carotid artery. A neurogenic tumour was considered, and the mass was excised from the vagus nerve with preservation of adjacent structures. Final histopathologic reading was schwannoma. However, the patient succumbed to complications following a second surgery for expanding hematoma. Conclusion:Schwannomas are benign, slow growing tumours that arise from Schwann cells of the nerve sheath. Cervical schwannomas originating from the vagus nerve are rare but should be considered in patients presenting with solitary neck masses. Surgical extirpation is still the treatment of choice for nerve sheath tumours and recurrence is uncommon. Efforts should be made to preserve unaffected structures and patients should be counseled preoperatively on the possible high risk of morbidity especially in the elderly group where close follow up and aggressive rehabilitation should be instituted following surgery.

Acute mastoiditis in a newborn complicated by the presence of facial nerve palsy is an alarming finding requiring rapid assessment and further investigation. Such an early presentation should point the clinician towards an underlying systemic pathology or congenital anatomical abnormality. Facial nerve involvement indicates severe infection and possible dehiscence of the facial canal. Although more frequent in children, it is rare in neonates. We would like to share our experience in managing the youngest known presentation of otomastoiditis at four days of life. The patient presented with otorrhea and facial paralysis and progressed to meningitis. He was finally diagnosed with chronic granulomatous disease.

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<p class="abstract">Carotid body tumour is a form of paraganglioma which arises from the carotid body. This tumour is known for its rich vascular supply mainly contributed by the ascending pharyngeal artery, a branch from external carotid artery. Surgical excision preceded by pre-operatic embolization remains the definitive treatment despite the countless feared complications. We present our experience with a case of carotid body tumour which was embolised prior to surgical excision, unfortunately complicated with a thromboembolic event. This patient was found to have an anatomical variation in the cerebrovascular anatomy known as a fetal posterior cerebral artery which led to a paradoxical PCA infarction post-embolization. We would like to highlight this rare presentation along with its management as there were scarce evidence of this case in the literature.</p>