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Case IA thirty year old male presented with complaints of simple snoring for the past 3 years. He had crescendo decrescendo type of breathing during this period. He did not complain of dysphagia, neck pain or limitation of neck movements. Examination revealed a hemispherical mass in the midline of the posterior pharyngeal wall measuring 2 cms x 2 cms in diameter extending from the level of the soft palate to the tip of the epiglottis, and laterally to the level of the posterior tonsillar pillar on either side. Mucous membrane over the swelling appeared healthy and on palpation revealed a bony hard, non tender smooth immobile mass. There was no cervical lymphadenopathy. On indirect laryngoscopy the mass was seen partially occluding the view of the laryngeal air way and both the vocal cords moved normally. Skiagrams of the cervical spine revealed a bridging osteophyte over the anterior aspect of C1 and C2 vertebrae (fig 1) with no evidence of sclerosis or erosion. The intervertebral space appeared normal. Ossification of the ligamentum nuchae was noted ( fig.l). Skiagrams of the lumbosacral spine and the dorsal spine were normal. Haematological investigations viz. Serum calcium, Phosphorous, Alkaline Phosphatase and proteins were not contributory. A mini sleep study (ECG monitoring, X-ray chest and. pulse oximetry) was done during sleep, were not contributory, Polysomonography

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The nasal airways and their close association to paranasal sinuses are an integral part of the Respiratory Tract. Mucociliary clearance is the predominant clearance mechanism for both upper and lower airways. The two components of mucociliary clearance are cilia and the secretions above them. It is known that CRS coexists in as many as 40-75% of patients with BA. Treatment options for CRS include medical therapy, surgical intervention or both. According to recent guidelines, ESS