One of the biggest concerns of many patients with rhinosinusitis before surgery is the problem of recurrence after surgery. According to the current international level of treatment, even a top international rhinologist cannot cure 100% of his patients without recurrence. For an experienced rhinologist, if his patients undergo standardized treatment, which includes systematic preoperative medication, perfect sinusitis, nasal polyp surgery, standardized postoperative follow-up and medication, 80-90% of the patients can achieve a good postoperative status, which is a good result, while there are still 10-20% of patients who may need another surgery after several years. The vast majority of my patients have a good recovery, also because I will repeatedly emphasize the importance of follow-up. Therefore, the entire treatment process is interlinked and equally important. Surgery is only half of the whole project, and the rest requires long-term, standardized postoperative follow-up. Patients with nasal polyps can usually be discharged from the hospital in three to five days after surgery, but this does not mean that the treatment is over, but that they have entered another phase. First follow-up visit The first follow-up visit is very important! Generally, patients in our hospital may be discharged soon after surgery, and the bedside doctor will perform a nasal clearance before discharge, but because the clearance is scheduled for 2-3 days just after surgery, the patient’s nasal cavity is still in a more serious state of edema at this time, and the doctor can only remove part of the exudate and accumulated blood from the nasal cavity, while the large amount of exudate and absorbable filling material in the middle nasal tract cannot be completely removed yet. If forcibly removed, it will cause pain and bleeding to the patient, leaving a psychological shadow, and some patients even told the doctor that “the surgery was not so unpleasant, but cleaning the nasal cavity made me very painful.” The first postoperative follow-up is usually one week after discharge, when the edema of the operative cavity has been reduced and the middle nasal passage is relatively easy to expose when cleaning, and the patient can tolerate it better at this time. At this time, the accumulated blood, absorbable stuffing material and pseudomembrane in the operation cavity can be removed more thoroughly, and the accumulated blood in the sinus cavity will be attracted to clean, generally at the end of the cleaning, patients often say “I think the symptoms before the operation have been reduced a lot, I didn’t think there were so many things in the nose, and now I feel more comfortable”. There are also some patients who do not pay attention to follow-up visits and do not come to the clinic even once after surgery. Although we did a very good job, but after a few months or even a few years, the patient’s nose has problems again, when they come back to the doctor for examination, they will find that the surgical cavity is a mess of adhesions, and then clean up at this time will miss the best time, and it will be too late to regret. After the first follow-up, the doctor will advise the patient to take the medication according to the situation, and arrange another follow-up, which will be scheduled according to the patient’s situation, usually one or two weeks later. Subsequent follow-ups will be extended according to the patient’s condition, and some patients who recover quickly may be scheduled for several months later. The general recovery time will vary from patient to patient, but if it goes well the condition is basically stable in three to six months, while patients with refractory sinusitis will require long-term follow-up. Post-operative medications Post-operative medications include antibiotics, nasal hormones, mucus-thinning medications, and Chinese medicines, which are similar to pre-operative medications, but because the surgery removes the lesion and opens the sinuses, the medications are more likely to work. Nasal rinsing Postoperative nasal rinsing can be started on the second or third day after surgery. Saline is the most commonly used and the most effective and safe rinsing solution. Theoretically, rinsing with saline can improve the oscillation of mucous cilia, wet the mucous membrane, and rinse away harmful substances. There are special devices and equipment that you can choose to use. Use of nasal hormones The use of nasal hormones is considered one of the highest and most effective methods recommended by evidence-based medicine, and is very important for the follow-up treatment of patients with rhinosinusitis, especially refractory rhinosinusitis, after surgery. Numerous randomized controlled studies have shown that nasal hormones can shrink nasal polyps and reduce the signs and symptoms of patients with few effects on the pituitary and adrenaline axis. For more information on how to use nasal hormones see my article on the topic. In conclusion, the treatment of sinusitis and nasal polyps requires long-term, standardized and comprehensive treatment, and post-surgical follow-up is one of the important aspects of treatment.