[Abstract] Objective To investigate the efficacy of nasal endoscopic surgery in the treatment of fungal sinusitis Methods Retrospective analysis of 17 patients with fungal sinusitis, all treated by nasal endoscopic surgery, complete removal of lesions and adequate open drainage. The clinical efficacy was observed and analyzed after the operation. Results Seventeen patients were followed up for 1-3 years, and the sinus cavity was free of fungi and inflammation on review, and all of them were cured without recurrence. Conclusion The treatment of fungal sinusitis by nasal endoscopic surgery is less traumatic, preserves the nasal sinus mucosa as much as possible during the operation, has a high cure rate, low recurrence rate, and exact efficacy, which is a more ideal treatment method. Due to the long-term unreasonable use of antibiotics and the aggravation of air pollution, the incidence of fungal sinusitis has been increasing in recent years, and there are various treatment methods for fungal sinusitis, and the traditional treatment method mostly uses Caldwell-luc surgery. Due to various reasons such as large trauma and poor local drainage, it often leads to poor postoperative outcomes. With the development of nasal endoscopic surgery, our department used nasal endoscopic surgery on 17 patients with fungal sinusitis from June 2003 to May 2007, and the results were satisfactory. The results are reported as follows.1. Data and Methods1.1 General Data Retrospective analysis of 17 patients with fungal sinusitis in our department from 2003-2006, including 7 male and 10 female cases. Age 30-65 years old, average 47 years old. The duration of the disease was 6 months-2 years, with unilateral maxillary sinus onset predominantly. The main clinical symptoms were blood in the mucus in 5 cases, nasal congestion with pus in 4 cases, unilateral facial and orbital pain in 4 cases, and recurrent headache in 4 cases. There were 3 cases with previous diabetes mellitus, 10 cases with long-term antibiotic use, and 4 cases with unknown causes. Examination CT scan showed flocculent calcified spots of maxillary sinus, which may be accompanied by bone destruction, maxillary sinus flushing as purulent with dark red blood, or containing gray or reddish-brown cheese-like material, and increased pressure during flushing with natural sinus orifice blockage. 1.2 Choice of surgical method anesthesia: 13 cases with general anesthesia and 4 cases with local anesthesia; 2. Patients were placed in supine position, 0°, 30° nasal endoscopy according to the extent of lesion and involved sinus For the maxillary sinus lesion, the maxillary sinus opening was enlarged under 30° endoscopy, and the lesion was removed by aspiration with an elbow suction, paying special attention to cleaning the medial wall of the maxillary sinus. The sinus cavity was observed according to the CT scan and different angles of nasal endoscopy, and the mucosal tissue of the fungal mass lesion in the sinus was completely removed, and the lesion at the bottom of the sinus cavity was removed by opening the inferior nasal passage if necessary. 100ML of 0.9% saline and 80,000 units of gentamicin were used to flush the surgical cavity, and no residue was checked. 2. According to the 1997 Haikou standard assessment (1).3. Results 17 patients were followed up for 1-3 years, none of them had recurrence, the sinus cavity mucosa recovered well after surgery, the sinus cavity was free of fungus and inflammation, no discomfort main report.4. When the resistance of the body or other reasons lead to narrow or occlusion of the drainage channel, sinusitis can be caused. The moist environment is conducive to the proliferation of fungi, and the lesion and anatomical variation of the sinonasal complex is an important factor leading to fungal sinusitis. The disease can be caused by obstruction of nasal and sinus drainage resulting in poor sinus ventilation and chronic inflammatory stimulation. Fungal sinusitis is divided into non-invasive and invasive types according to the fungal component staying on the mucosal surface, or invading the mucosa or intra-mucosal vessels to the sub-mucosal bone wall. Fungal non-invasive sinusitis is common in clinical practice, and the main causative agent is Aspergillus (3). It occurs in adult females. In this study, 17 patients belonged to this type, and 67% of them (10 cases) were female. The main manifestations were nasal congestion, runny nose, blood in the nose, headache and facial pressure, etc. The lesions were mostly confined to one sinus cavity, with the maxillary sinus being the most common, followed by the septal sinus, and rare in the pterygoid sinus or frontal sinus. Surgery is the main treatment for fungal sinusitis, which can completely remove all fungal masses and other contents from the sinuses and ensure adequate drainage and ventilation for a long time after surgery, thus changing the environment in which the fungi live (4). The traditional Caldwell-Luc procedure is less and less used clinically because of the large trauma, complications such as facial pain or numbness, toothache, gingival pain or numbness, inability to deal with lesions of the sinonasal complex and nasal septum, and unsatisfactory treatment of the sinus drainage opening. The nasal endoscopic surgery can reduce the invasive operation, less trauma, less patient pain, and can better solve the problem of nasal sinus drainage in patients with sinus fungal disease, establish good ventilation and drainage channels, remove the microenvironment in which the fungus lives, and facilitate postoperative review and follow-up, easy postoperative cleaning of the operative cavity, can simultaneously deal with the septal sinus, pterygoid sinus, nasal septum and other lesions, high cure rate, and can correct the causes of fungal It can also correct the causes of fungal sinusitis, such as middle turbinate lesions, deviated nasal septum, nasal polyps, etc. (5), thus avoiding or reducing its recurrence rate. It has been widely used in clinical practice. About the use of postoperative antifungal drugs and antibiotics. Because fungal sinusitis is a non-invasive type, the prognosis of surgery is good, so antifungal drugs are not needed. Because macrolides can reduce the secretion of nasal mucosa and increase the mucus transport function, and can prevent postoperative bacterial infection (6). Postoperative irrigation of the sinus cavity with 5% sodium bicarbonate solution can change the pH environment of the sinus cavity to inhibit the growth of fungi. All 17 cases in this group underwent nasal endoscopic surgery with satisfactory treatment results and no complications.