Background: Baraitser–Winter Syndrome (BRWS) is a rare autosomal dominant condition associated with hearing loss (HL). In the literature, two types of this condition are reported, Baraitser–Winter type 1 (BRWS1) and type 2 (BRWS2) produced by specific pathogenetic variants of two different genes, ACTB for BRWS1 and ACTG1 for BRWS2. In addition to syndromic BRWS2, some pathogenic variants in ACTG1 are associated also to another pathologic entity, the “Autosomal dominant non-syndromic hearing loss 20/26”. In these syndromes, typical craniofacial features, sensory impairment (vision and hearing) and intellectual disabilities are frequently present. Heart anomalies, renal and gastrointestinal involvement and seizure are also common. Wide inter- and intra-familial variety in the phenotypic spectrum is reported. Some phenotypic aspects of these syndromes are not yet fully described, such as the degree and progression of HL, and better knowledge of them could be useful for correct follow-up and treatment. Methods and Results: In this study, we report two cases of children with HL and diagnosis of BRWS and a review of the current literature on HL in these syndromes.

Background: Bilateral facial nerve palsy (BFNP) is a rare clinical entity in children and is more often associated with systemic or infectious diseases than unilateral facial palsy. Epstein–Barr virus (EBV) infection is an uncommon but recognized cause of facial nerve palsy and may present with bilateral involvement. Case presentation: We report the case of a 3-year-old boy who presented with progressive bilateral facial weakness following a febrile illness with pharyngitis and cervical lymphadenopathy. Neurological examination revealed complete bilateral facial paralysis (House–Brackmann grade VI). Laboratory investigations showed lymphocytosis and confirmed acute EBV infection through positive viral capsid antigen IgM and detectable EBV DNA in peripheral blood. Cerebrospinal fluid analysis demonstrated mild pleocytosis with negative EBV DNA. Brain magnetic resonance imaging revealed unilateral enhancement of the left facial nerve. Audiologic evaluation supported peripheral facial nerve dysfunction. The patient was treated with systemic corticosteroids, vitamin B complex supplementation, artificial tears, and speech therapy, resulting in gradual and substantial clinical improvement over five months. Discussion: A review of the pediatric literature identified only six previously reported cases of EBV-associated BFNP. The pathogenesis may involve either direct viral neurotropism or a post-infectious immune-mediated mechanism. Diagnostic evaluation is essential to exclude other serious causes of BFNP, particularly Lyme disease and Guillain–Barré syndrome. Conclusions: EBV infection should be considered in the differential diagnosis of BFNP in children. Prognosis is generally favorable, although recovery may be prolonged. Further studies are needed to clarify optimal diagnostic and therapeutic approaches.

Objective: This study aimed to determine whether radiologic and clinical data can predict the cochlear implant (CI) benefit in patients with otosclerosis, with a focus on the prognostic value of computed tomography (CT) features and relevant clinical variables. Methods: A retrospective single-centre analysis was conducted on 126 otosclerotic patients (143 implanted ears) who underwent CI between 2009 and May 2025. Preoperative and postoperative CT scans were reviewed and classified using established grading systems (Symons/Fanning, Rotteveel, Veillon). Clinical variables included age at implantation, duration of hearing loss (HL), preoperative audiometric thresholds, history of stapes surgery, electrode design, and scala of insertion. Audiological outcomes were evaluated at 12 months postactivation using aided pure tone average and aided speech perception score. Univariate and multivariate statistical analyses were performed. Results: No significant correlation was found between CT-based otosclerosis staging or radiologic features and post-CI audiological outcomes. Multivariate analysis identified increased age at implantation, electrode insertion into the scala vestibuli, and use of straight electrodes as predictors of poorer speech perception. A longer duration of HL also negatively impacted outcomes. Precurved electrodes and scala tympani placement were associated with superior results. Previous successful stapes surgery predicted better performance. Conclusions: While CI provides effective auditory rehabilitation in otosclerotic patients, radiologic CT staging does not predict functional outcomes. Instead, clinical factors—age, duration of HL, electrode design, and array placement—are more influential. Preoperative CT remains essential for surgical planning, but patient counselling should focus on clinical history and procedural details. Level of Evidence: Level III.

There are several pathologies that can change the anatomy of the otic capsule and that can distort the bone density of the bony structures of the inner ear, but otosclerosis is one of the most frequent. Similar behavior has been shown in patients affected by osteogenesis imperfecta (OI), a genetic disease due to a mutation in the genes coding for type I (pro) collagen. In particular, we note that otosclerosis and OI can lead to bone resorption creating pericochlear cavitations in contact with the internal auditory canal (IAC). In this regard, in our experience we have collected 5 cases presenting this characteristic and their audiological data and clinical history were analyzed. This feature can be defined as a potential cause of a third-window effect, because it causes an energy loss during the transmission of sound waves from the OW away from the basilar membrane.

There are several pathologies that can change the anatomy of the otic capsule and that can distort the bone density of the bony structures of the inner ear, but otosclerosis is one of the most frequent. Similar behavior has been shown in patients affected by osteogenesis imperfecta (OI), a genetic disorder due to a mutation in the genes coding for type I (pro) collagen. In particular, we note that otosclerosis and OI can lead to bone resorption creating pericochlear cavitations in contact with the internal auditory canal (IAC). In this regard, we have collected five cases presenting this characteristic; their audiological data and clinical history were analyzed. This feature can be defined as a potential cause of a third-window effect, because it causes an energy loss during the transmission of sound waves from the oval window (OW) away from the basilar membrane.