Introduction Olfactory neuroblastoma originates from the neuroectoderm of the olfactory nerve and accounts for 3% of nasal tumors. Because the exact tissue origin is not clear, it has been named as olfactory neuroblastoma, olfactory neuroblastoma (ONB), and esthesioneuroblastoma (ENB). The 1993 WHO Pathologic Classification of Tumors classifies olfactory neuroblastoma as a neuronal tumor and includes olfactory neuroepithelioma in parentheses. The disease can be seen at any age, with a double peak between the ages of l0-20 and 50-60, and is more common in males. The tumor usually occurs in the top, upper and lateral walls of the nasal cavity, with a slow progression and locally aggressive growth, invading the septal sinus, maxillary sinus, pterygoid sinus and frontal sinus, as well as the orbit, nasopharynx and intracranium. In the early stage, the main symptoms include nasal congestion, rhinorrhea, headache, runny nose, loss of smell and other symptoms of chronic sinusitis, with the highest rate of loss of smell. In the progressive stage, patients may also develop ocular symptoms such as tearing, proptosis, diplopia and visual impairment. Very few patients develop neuropsychiatric symptoms such as convulsions and loss of consciousness. On examination, the tumors in the upper part of the nasal cavity are grayish-red, brittle and bleed easily when touched. At present, the clinical staging of this disease is mostly proposed by Kadish et al: stage A tumor is confined to the nasal cavity; stage B tumor invades the sinuses; stage C tumor is beyond the nasal cavity and sinuses and may invade the sieve plate, orbit, skull base, neck or distant metastasis. CT can well indicate the damage of tumor tissue to its surrounding bone structure, while MRI can clearly show the extent of infiltration of tumor tissue into adjacent soft tissues, especially intracranial and orbital areas. The diagnosis and differential diagnosis of ENB is insidious and the clinical manifestations are non-specific. The diagnosis depends mainly on pathological examination. The tumor needs to be differentiated from undifferentiated carcinoma, malignant lymphoma, and embryonal rhabdomyosarcoma under low magnification. Treatment Since its first report by Berger in 1924, more than 1,000 cases have been reported. Treatment of olfactory neuroblastoma includes surgery alone, radiotherapy, surgery combined with radiotherapy, but the role of chemotherapy cannot be determined and there is no standard chemotherapy regimen. Currently, the main treatment is a combination of surgical treatment. Depending on the surgical pathway, it is divided into nasal outer diameter surgery and transnasal nasal endoscopic surgery. In addition to facial scarring and possible deformities, the following perioperative and postoperative complications can occur in some cases: persistent cerebrospinal fluid leak, frontal valve abscess, cranial pneumoperitoneum, subdural hematoma and infection, forehead bone cap necrosis, frontal sinus mucus cyst, tear duct stenosis, and unilateral blindness. Intranasal approach surgery. (2) The outward bony border is preserved, reducing the possibility of cyst formation and avoiding the impact on the facial and cranial development of young patients; (3) Meningeal defects from the lower posterior wall of the frontal sinus to the middle of the plane of the butterfly and laterally to the cardboard can be repaired microscopically or endoscopically via this route; (4) Facial scarring is avoided. (iv) avoiding facial scarring and deformity. Preoperative radiotherapy can effectively reduce the size of the tumor and enable complete nasal endoscopic resection of larger tumors. Postoperative radiotherapy can reduce tumor recurrence and improve the efficacy. Most scholars believe that the prognosis of ENB is related to the Kadish stage. The 5-year survival rates for stage A, B, and C of the disease are estimated to be 75%, 68%, and 41%, respectively.