We described a case of congenital atresia of the anterior nares with a minute opening on the right side and underdevelopment of the nasal cavities. The hard palate was flat and the soft palate was normally mobile. Right anophthalmia and microphthalmia of the left eye with iris coloboma were also noted. In order to provide a nasal airway and to enable the newborn to suck and breathe simultaneously the patient was operated on at four days of age. By means of transpalatal approach a nasal cavity was drilled out of solid bone and connected with the small anterior duct. Trough the new created air duct a nasopharyngeal tube was introduced. In spite of that the external nasal orifice was enlarged later, there was an inclination the orifice to collapse due to lack of nostril cartilages, therefore a nasopharyngeal tube still is used. The physical and intellectual development of the now 11-month old infant is normal. Final reconstruction of the external nose will take place later.