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Children with gross hydrocephalus present various challenges to the anaesthesiologists. The problems encountered are not only limited to associated congenital abnormalities and physiological derangements due to raised intra cranial tension, even intubation in such cases can pose great difculty owing to the increased head circumference that makes the alignment of oro-pharyngo- [1,3] laryngeal axis under direct laryngoscopy almost impossible . Difcult airway cart, C- MAC, paediatric breoptic bronchioscope and all possible difcult airway armamentarium must be checked to be in place before induction of anaesthesia in such cases to potentially avoid any [2] airway disaster . Here is a case report of a child with gross hydrocephalus posted for emergency VP shunt placement that turned out to be an extremely challenging airway.

Sphenochoanal polyp are rare tumours arising from sphenoid sinus. The main presenting complain is gradually progressing nasal obstruction. Sphenochoanal polyp mimics antrochoanal polyp clinically. To differentiate it from antrochoanal polyp, diagnostic nasal endoscopy, computer tomography and magnetic resonance imaging of the paranasal sinuses are the investigation of choice. Functional endoscopic sinus surgery is the line of treatment.: A 33years old female presented with right nasal obstruction since 2 years. On Diagnostic nasal endoscopy polypoidal mass was seen partially obliterating the right nasal cavity not arising from middle meatus. CT scan showed polypoidal mass obliterating the nasal cavity, choana and Sphenoid sinus. It was completely excised by functional endoscopic surgery.We present this rare case to highlight the use of diagnostic nasal endoscopy and Computed Tomography in the diagnosis and treatment of Sphenochoanal polyps