The facial nerve, the seventh pair of cranial nerves, has an essential role in non-verbal communication through facial expression. Besides innervating the muscles involved in facial expression, the complex structure of the facial nerve contains sensory fibres involved in the perception of taste and parasympathetic fibres involved in the salivation and tearing processes. Damage to the facial nerve manifested by facial paralysis translates into a decrease or disappearance of mobility of normal facial expression.Facial nerve palsy is one of the common causes of presenting to the Emergency Room. Most facial paralysis are idiopathic, followed by traumatic, infectious, tumor causes. A special place is occupied by the child’s facial paralysis. Due to the multitude of factors that can determine or favour its appearance, it requires a multidisciplinary evaluation consisting of otorhinolaryngologist, neurologist, ophthalmologist, internist.Early presentation to the doctor, accurate determination of the cause, correctly performed topographic diagnosis is the key to proper treatment and complete functional recovery.

Septal perforation is a nasal condition discovered incidentally during an ENT clinical examination. Sometimes, patients may experiment epistaxis, septal crusts at the edge of perforation, nasal obstruction, whistling, rhinorrhea or even pain. Doctors should be familiarized with the etiology of septal perforations in order to apply the best treatment possible. This etiology includes some of the following: iatrogenic, self-injury, drugs, inflammatory diseases, etc. A very good anamnesis and clinical examination should be performed. Also, paraclinical investigations are required depending on the particular situation. Treatment should be individualized and may include conservational techniques or applying of grafts/flaps for closing the septal perforation. In this article, some of the most frequent causes of septal perforation are reviewed, with some examples from our clinic and short reminder of steps to be taken in this case.

BACKGROUND. Medulloblastoma is the most common central nervous system embryonal tumor in children. In adults, this tumor is extremely rare, accounting for nearly 1% of primary brain tumors. Raised intracranial pressure signs are common manifestations of posterior fossa tumors, but tinnitus and/or sensorineural hearing loss are very uncommon presenting symptoms. MATERIAL AND METHODS. Starting from a very rare case of a 39-year-old male with left tinnitus and progressive left sensorineural hearing loss as isolated symptoms of a medulloblastoma, we performed a literature survey using the PubMed, ProQuest, Web of Science, Science Direct, Wiley Online search engines for patients with medulloblastoma and tinnitus and/or sensorineural hearing loss. RESULTS. All patients found in the relevant literature with auditory dysfunctions presented sensorineural hearing loss. Other frequent manifestations were: ataxia, facial numbness, vertigo, headache, nystagmus. Two patients were found with tinnitus and sensorineural hearing loss as isolated symptoms of medulloblastoma, as in our case, and in two other cases the sensorineural hearing loss was the unique symptom. With refers to the onset of medulloblastoma, just 3 patients had the first symptoms sensorineural hearing loss and tinnitus. Concerning the tumor location, in patients manifested with isolated tinnitus and sensorineural hearing loss, like our patient, the tumor arised from the internal auditory meatus, extended to the cerebellopontine angle or involved the vestibulocochlear nerve. With regards to treatment, surgery in association with radiotherapy and chemotherapy was elected in most cases (38%). CONCLUSION. It is important to pay attention at patients with isolated auditory dysfunction that may mimic significant posterior fossa tumors, such as a medulloblastoma.

Chronic rhinosinusitis (CRS) is one of the most common chronic inflammatory syndromes reported in the general population, with high prevalence reported. It is classified in two distinct entities depending on the endotype dominance, either type 2 or non-type 2, – chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps. CRSwNP is described as a type 2 inflammatory disease, with the implication of T-helper 2 inflammation mechanisms with a secondary increase in the concentration of eosinophils and total Immunoglobulin E. CRSwNP is characterized by a high recurrence rate even after endoscopic sinus surgery. Considering the challenges associated with the treatment of CRSwNP, new medical therapies, such as monoclonal antibodies, have been developed over the years. Biologics with anti-IL-5, anti-IgE, anti-IL-4 receptor alpha (IL-4-Rα) action have been developed and tested for the treatment of asthma, eosinophilic dermatitis, and secondarily evaluated and approved for the treatment of chronic rhinosinusitis with nasal polyps. In this review, we make a synthesis of the monoclonal antibodies available and their efficacy and safety in the treatment of nasal polyposis.