Zhang Liqiang, Department of Otorhinolaryngology, Qilu Hospital, Shandong University Nasal congestion caused by nasal stenosis and a variety of head discomfort symptoms are more common in clinical practice. This part of the patient is mostly caused by the narrowing of the anatomical structure, drug treatment is often ineffective. Part of the patient is due to childhood adenoid hypertrophy, long-term open-mouth breathing, nasal waste development disorder, resulting in excessive narrowing of the nasal cavity, the patient’s hard palate high arch, and its sinuses, especially the maxillary sinuses can be compensatory overdevelopment, so that the patient appeared to be a “small nasal cavity, large sinuses” phenomenon. These patients are also more likely to snore in adulthood. Nasal congestion caused by the structural narrowing of the nasal cavity is different from that caused by chronic rhinosinusitis, which can be treated with medication to get better results, while the former requires surgery. Due to the structural narrowness of the nasal cavity, the additional space gained by surgery is not large, and often requires multi-structural treatment in order to achieve a better clinical outcome. In our experience, the improvement of nasal congestion by surgical treatment can be mostly achieved with positive results. However, the degree of improvement in nasal congestion is often not entirely consistent between what is seen intraoperatively and the patient’s subjective perception. In patients with coexisting allergic rhinitis, the nasal volume is slightly enlarged, and the patient can feel a significant improvement in nasal congestion. This may be related to the fact that patients with allergic rhinitis have long-term edema of the nasal mucosa, the nasal cavity volume is small, and the patients have adapted to the narrow nasal cavity. Some patients have a history of multiple surgeries, the nasal mucosa is more damaged, and despite the spaciousness of the nasal cavity after surgery, patients still feel nasal congestion. These patients may have damaged pressure receptors on the surface of the nasal mucosa, resulting in pseudo-obstruction. Since the airflow into the nasal cavity flows parabolically through the anterior end of the middle nasal passage, bilateral leptotomy, anterior sieve opening, or middle turbinoplasty in patients with excessive nasal stenosis can significantly reduce nasal congestion in patients. For the management of the inferior turbinate, our principle is to perform submucosal osteotomy of the inferior turbinate as much as possible, preserving more mucosa of the inferior turbinate. The anterior end of the inferior turbinate is an important structure that generates nasal resistance. When performing inferior turbinate osteotomy, the bone at the anterior end of the inferior turbinate must be adequately resected. The posterior end of the inferior turbinate has less bone, but the submucosal tissues are more hypertrophic, so some of the submucosal and mucosal tissues on the lateral side of the posterior end of the inferior turbinate can be appropriately resected. Care should be taken to avoid damaging the mucosa of the Eustachian tube orifice during resection. Deviated nasal septum tends to affect the passage of nasal airflow, and it is necessary to correct the nasal septum to a more or less normal state in order to improve nasal congestion. Since nasal airflow is parabolic through the nasal cavity, high septal deviation must be adequately corrected. Dizziness, headache and heaviness are another group of more common clinical symptoms. The spines or ridges formed by a deviated septum can form mucosal contact points with the inferior or middle turbinate causing head discomfort. In patients with a deviated septum, the nasal cavity changes in volume as the middle and inferior turbinates and even the sieve bubbles adapt to the shape of the nasal cavity. For example, the inferior turbinate on the spacious side of the nasal cavity will undergo compensatory hyperplasia, the inferior turbinate bone may undergo adduction, bone thickening, submucosal tissues become hypertrophied, and the inferior nasal passage becomes spacious. The middle turbinate undergoes vesicular changes, and the sieve vesicle is hyperpneumatized. And the various structures on the narrowed side of the nasal cavity undergo corresponding changes. Volume is reduced and the nasal passages are narrowed. All of these can create mucosal contact points that lead to a variety of head discomfort symptoms. Surgical correction of a deviated septum and management of the inferior turbinate, middle turbinate, hooks and sieve vesicles can be effective in alleviating a variety of head complaints. Patients with chronic rhinitis can also experience head discomfort due to the formation of mucosal contact points in the inferior or middle turbinate due to hyperplasia. Turbinate reduction through inferior and middle turbinateplasty may also improve these symptoms. It should be noted that not all head discomfort is of nasal origin. Some may be neurologic migraines or neuralgia. Nasal headaches usually present as a dull ache that worsens with a cold or when a sinus infection worsens. Migraine headache can be accompanied by vegetative symptoms, such as severe headache with nausea, vomiting and photophobia. Neuralgia, on the other hand, manifests itself as episodes of severe headache, which are short-lived and may last only a few minutes. These need to be managed in the differential with a neurologist. Runny nose is one of the more difficult clinical symptoms to manage, and most often requires systemic medication for relief. Surgery may provide a better condition for recovery of the lesion with medication. Surgery by itself is not a good solution to the symptoms of runny nose. Nasal hormones can improve the inflammation of the nasal sinus mucosa, reduce mucosal secretion, coupled with the application of mucus drainage agents, can effectively treat runny nose. However, some patients with postnasal drip are more difficult to manage. Those caused by inflammation of the sinuses or nasal mucosa can be treated with medication or surgery. Some postnasal drip is caused by changes in the composition of the mucus secreted by the mucous membranes or by hypersensitivity of the patient’s senses, and treatment is less likely to be successful.