Congenital nasal disorders in infants and children are a very rare category of diseases. Common diseases include congenital meningeal brain expansion, posterior nostril atresia, nasal hemangioma, tumors of the nasal cavity and sinuses, etc. The clinical manifestations of these children are mainly manifested as one or bilateral nasal obstruction found after birth or soon after birth, leading to breathing difficulties, feeding difficulties, and in severe cases, lung infections and intracranial infections. Therefore, if once found, early treatment should be given. The following is some introduction to the etiology and clinical manifestations, diagnosis and treatment of these diseases. First, congenital meningeal brain expansion Meningeal or meningeal brain expansion refers to the meninges or meninges and brain tissue from the congenital defect of the skull, that is, the cranial fissure outward expansion, its incidence varies from report to report, the formation of the cause is not yet fully understood, some people believe that it may be related to the neural tube closure disorder [1], but most scholars believe that it occurs shortly after the neural tube closure, brain tissue through the development of the formation of the skull and The dura mater is a region of mesenchymal defect that expands. Depending on the extent of the bulge and the different contents of the bulge, it is classified into three categories: meningeal bulge, meningeal brain bulge, and ventriculocephalic bulge, and the capsule formed may contain brain tissue or cerebrospinal fluid. Clinically, the meningoencephalic bulges are classified into three major categories according to their location: retrooccipital, fontanelle, and basal, with the main type being retrooccipital, accounting for about 75%. Those related to rhinology are fontanelle type and basal type. The fontanelle type includes the nasal frontal type, the nasal sieve type and the nasal orbit type; the basal type is divided into the nasal blade type and the nasal blade type. The bregma type masses are more likely to be bulging out of the nose and are easier to diagnose, while the basal type are more likely to be bulging out of the nose. The clinical manifestations are mainly nasal obstruction on one or both sides, which often leads to difficulty in breathing and feeding due to nasal obstruction; examination reveals smooth neoplastic surface of the nasal cavity or nasopharynx, and the masses are found at the top of the nasal cavity or in the nasopharynx, with clear fluid flowing out of the nasal cavity if they are broken. Meningocele in the nasal cavity should be distinguished from nasal polyps, nasal tumors and hemangiomas. Imaging examination can generally make a clear diagnosis, coronal sinus CT can generally detect the skull base bone defects, but newborns because of its incomplete cranial calcification, cranial translucency, sometimes difficult to determine the cranial defects; MRI on the cranial defects is not as clear as the resolution of CT, but the contents of the bulge is higher resolution, can observe the subarachnoid space, brain parenchyma, ventricular morphology, significantly better than CT, and to T2 coronal and sagittal views can well show the density of the nasal mass and the relationship with the meningeal brain tissue. Therefore, imaging examination can clearly diagnose and accurately determine the site and size of skull base defect, and also has important significance for the surgical selection. Once the diagnosis of meningoencephalic bulge is clear, early surgery is recommended. If surgery is not performed as early as possible, it can easily lead to intracranial infection in case of rupture or fever. The traditional method is craniotomy or combined cranionasal approach, however, craniotomy is highly injurious, prone to serious postoperative complications, and too young children have poor tolerance and high risk, so it is not advocated to operate too early. At present, the main treatment method we use is nasal endoscopic transsphenoidal approach for meningoencephalic bulge excision and skull base repair. Nasal endoscopic meningoencephalic bulge surgery has the advantages of small surgical trauma, clear surgical field, and few postoperative complications, etc. For children under 2 years old, the surgery is still very safe, and the youngest of our patients is 49 days after birth, with good postoperative recovery and no complications. Congenital posterior nostril atresia Congenital posterior nostril atresia is a rare congenital malformation, the incidence is about 1/8000, unilateral posterior nostril atresia is common, bilateral complete atresia is rare, most atresia is membranous or mixed, bony atresia is about 30%. There are many teratogenic theories of congenital posterior nostril atresia, and the more recognized ones are caused by the nasobuccal membrane or buccopharyngeal membrane left behind during embryonic development, or the posterior nostril being obstructed by epithelial masses. Unilateral posterior nostril atresia generally has mild symptoms, mainly unilateral nasal congestion and nasal secretions, which are often not detected early by parents; complete bilateral posterior nostril atresia has more severe symptoms, with paroxysmal cyanosis at birth, difficulty in breathing and breath-holding when suckling, and relief of symptoms when crying with open mouth, and more nasal secretions, often accompanied by pulmonary infections; these newborns These newborns are often admitted to the NICU because of pulmonary infections. The diagnosis of posterior nostril atresia is generally easy, and common diagnostic methods include introducing a thin catheter into the nasal cavity and observing whether it can reach the pharynx, or injecting a little Meridian blue into the nasal cavity and checking whether there is blue color in the pharynx; these are the most simple and direct diagnostic methods, but they cannot determine the site, nature, degree of atresia and the relationship with the surrounding tissues. CT examination has important clinical significance in the diagnosis of congenital posterior nasal atresia, and can accurately determine the nature, location and degree of atresia. Unilateral congenital posterior nostril atresia does not require timely treatment because the symptoms are mild, and the timing of surgery can be determined after 2 years of age according to the child’s growth and development. However, bilateral posterior nostril atresia is recommended to be operated as early as possible because the symptoms are severe and can cause feeding difficulties and growth and development of the child. At present, we perform posterior nostril atresia by combined nasal and palatal pathway under nasal endoscopy, and place a U-shaped posterior nostril ventilation tube for about 3 months after surgery. It is very important to take care of the nasal cavity after posterior nostril atresia surgery. It is important to clean the nasal cavity with saline every day to keep the nasal cavity clear and regular follow-up nasal endoscopy is also very important. However, because children are too young, they often cannot cooperate well. As a health care worker, we should patiently guide the family members on how to perform nasal flushing and postoperative care. The congenital nasal sinus tumors in children are relatively rare, benign and malignant. Malignant tumors include embryonal rhabdomyosarcoma, while benign tumors include glioma, hemangioma, and malignant tumor. We have seen hemangiomas and malignant tumors that present as nasal masses found after birth, which severely affect the child’s sleep and breathing, and most of these children are diagnosed as meningocephalic bulges in outside hospitals. How to accurately determine whether the mass is a meningoencephalic bulge or a tumor is mainly diagnosed by imaging, both CT and MRI examinations are necessary. CT can determine whether there is a skull base defect, but because of the child’s young age, sometimes CT shows a bone defect at the skull base which often leads to misdiagnosis, MRI can accurately determine whether the tumor comes from the skull base. Generally, if a tumor is found in the nasal cavity, early surgery is recommended.