**Abstract**

REAH is the eponym for respiratory epithelial adenomatoid hamartoma. The disease is under diagnosed. It is clearly a disease in the olfactory cleft. It is characterized by a polypoid process located in the olfactory cleft which does not evolve in inverted papilloma or malignancy set at 10–15 cm. The lesion can be isolated in one or both olfactory cleft. It can be asymptomatic or can cause nasal obstruction and impairment of smell. More commonly the lesions, often multiple, are associated to the recurrence of the nasal polyposis. They can contribute to the development of loss of smell, nasal obstruction or even the blockage of the frontal recesses. The definitive diagnostic is based upon the histologic examination. Surgery is the treatment. In case of isolated lesion, complete excision without complete ethmoidectomy is the option. In case of lesions embedded in a recurrent massive polyposis, a complete exenteration of the olfactory clefts associated to a revision of full house ethmoidectomy and even a Draf III must be considered.

**Keywords:** REAHs, REAH-like, nasal polyposis, olfactory cleft
