Introduction: Thornwaldt's cyst is defined as “an inconstant blind sac located above the pharyngeal tonsil in the midline of the posterior wall of the nasopharynx .It is usually a developmental abnormality where communication between pharyngeal endoderm and notochordal remnants persist. Case Report: 32 yr old male, presented with bilateral decreased hearing since 2 and half years, with no other ear symptoms. Audiogram showed bilateral Conductive Hearing loss, with Impedence audiogram showing bilateral type B curve. X ray soft tissue neck lateral view showed soft tissue mass occupying nasopharynx with no crescent sign. CT scan of Paranasal sinuses and nasopharynx was suggestive of midline cystic mass arising from roof of nasopharynx. Patient was taken up for nasal endoscopic surgery. Cyst content was sent for Histopathology reporting which showed respiratory epithelium suggesting Thornwaldt’s cyst. Conclusion: Thornwaldt’s cyst is a rare entity. Patients may present with only Bilateral decreased hearing. And if Tympanometry is suggestive of type B curve then the patient should be further evaluated and posted for CT scan of nasophartnx to rule out the diagnosis of Nasal mass. The possibility of Thornwald cyst should be kept in mind even though it is a rare entity. The final diagnosis can be confirmed with histopathology report.
