Observation of an attendant of a patient, a 55 year old woman, exposed a case of anatomical curiosity, an uncommon variant of a developmental anomaly, an atypical facial and palatal cleft, and a rare association of a hypoplastic maxillary sinus. The woman gave history of effectively managing the deformity with certain habituated maneuvers of the tongue, without undergoing any surgical, cosmetic or functional correction. Such cases need to be documented to create awareness as these developmental pathologies with sinus opacity may be misdiagnosed as sinusitis or neoplasm.
