Sinusitis is a common disorder in otorhinolaryngology-head and neck surgery, causing discomfort such as nasal congestion, runny nose, headache and loss of smell, which can seriously affect the quality of life of patients. What are sinuses? Sinuses are bony cavities that communicate with the nasal cavity and are covered with mucous membranes. These sinuses are like several rooms that are connected to the nasal cavity, the living room. The presence of these sinuses (i.e., the bony cavities surrounding these nasal passages) reduces the weight of the head, decreases the pressure of the head on the neck, and also serves to warm and humidify the air and improve pronunciation. These sinuses are identical and connected to the mucous membrane of the nasal cavity and can also become inflamed, known as sinusitis (also called rhinosinusitis). How can I tell if I have sinusitis? First of all, if you have the symptoms mentioned above, the doctor can find pus in the nasal cavity, and sometimes there is pressure and pain in the face or around the orbital area, combined with the medical history, the initial diagnosis of “sinusitis” can be made. Because sinus is a cavity in the skull, the doctor cannot see whether it is inflamed or not. Therefore, to further clarify the diagnosis, imaging tests, such as sinus CT, are required to determine whether sinusitis is present and which sinus is present. How should sinusitis be treated? In case of acute sinusitis, i.e., if the disease has not exceeded 3 months, the first choice is medication, including antibiotics and drugs to promote the elimination of pus, nasal decongestants such as ephedrine and daphenhydramine, and nasal irrigation. For chronic sinusitis with a duration of more than 3 months or recurrent episodes, medication can be used first, and surgery can be considered if conservative treatment is not satisfactory. Can sinusitis be cured by surgery? ”Endoscopic surgery can effectively improve the ventilation and drainage of the inflamed sinuses, and therefore has a significant effect on inflammation or infection. However, endoscopic sinus surgery may not completely solve some annoying minor problems of sinusitis patients. For example, patients want to solve the problem of backflow of nasal mucus caused by sinusitis. In fact, all people have a natural flow of snot to the back nostrils, which we then swallow into the stomach where it is sterilized by stomach acid. However, some patients with rhinitis and sinusitis still have nasal reflux even though they have undergone surgery to cure the severe sinus obstruction, inflammation and these accompanying dizziness, headache and loss of smell. This may be related to the patient’s own immune status of the nasal cavity, the quality of the outside air and the continuous low intensity inflammatory state of the nasal cavity, which cannot be completely eradicated by surgery. Therefore, it is difficult to achieve 100% comfort after surgery for sinusitis. However, surgery can often be a good solution to nasal congestion symptoms. Therefore, before undergoing surgical treatment, it is important to see not only the results that surgery can bring, but also the limitations of surgery and to have a full understanding of the prognosis of sinusitis surgery without being disappointed. We currently have a cure rate of over 90%, and there are still about 10% of patients who have recurrent refractory sinusitis. So which patients are likely to benefit from surgery? The efficacy of surgery must be evaluated prior to surgery to see if it will meet the patient’s treatment requirements. Patients with sinusitis and nasal polyps that do not resolve after regular medication and have recurrent episodes are most likely to benefit from surgery. Is there a risk associated with surgery? The first thing to know is that there are risks associated with any surgery, and sinus surgery is no exception. The nasal sinuses are closely related to the orbital and cranial cavities. The operation is performed close to the eyes and brain, so there are risks involved. The patient’s general condition, such as age, cardiopulmonary status, blood pressure and blood glucose level, affects the surgery. Detailed preoperative examination, evaluation and preparation, intraoperative surgeon’s technique, good postoperative treatment and follow-up, and adequate communication between the patient and the surgeon help to minimize the occurrence of surgical complications. Post-surgical precautions? The purpose of sinusitis surgery is to open up the sinuses in the nose so that the traffic between these bony cavities and the nasal cavity is smooth and no longer accumulates secretions and inflammation and infection inside. So the surgery is to create the conditions for the inflammation to recover, just like a room with closed doors and windows and mold inside. We go and open the doors and windows, clean them and keep the door of this room open and no longer moldy. Therefore, surgery does not solve all the problems. If the outside air is poor, if the patient’s immune system is low or if the sinuses that have been opened are closed again due to contracture of the scar, the patient’s sinuses may still become inflamed and infected. Therefore, some medication is still necessary after surgery, such as nasal corticosteroid spray and nasal irrigation. In addition, post-operative follow-up is important, as it enables the doctor to understand the patient’s post-operative recovery and to give timely treatment to any problems that may arise or have arisen, in order to facilitate the patient’s recovery. The treatment of sinusitis requires the joint efforts of doctors and patients to achieve good results!