Dysfunction of the last cranial pairs can occur in some neurological diseases, such as Chiari's malformation. This entity causes herniation of the cerebellar amygdalas through the foramen magnum, producing descent of the brainstem and traction on the lower cranial pairs. This dysfunction occurs in 57-70% of patients with this malformation, which is why the disease may be diagnosed in the ENT clinic. Clinical suspicion of this entity after exhaustive examination of the patient, early disease diagnosis and correct selection of surgical treatment can alleviate major symptoms and prevent neurological complications in some cases.