【Abstract】Objective To explore the significance of regular follow-up after nasal endoscopy for chronic rhinosinusitis and nasal polyps. Methods From April 2001 to April 2005, 308 patients (530 sides) with chronic sinusitis and nasal polyps underwent nasal endoscopic surgery in our department. Except for 424 patients (68 sides) whose follow-up observation process was irregular, the remaining 266 patients (462 sides) underwent regular follow-up and cleaning of the surgical cavity. We compared and analyzed the effects of different follow-up experiences on the recovery process of the two groups. Results: Among the patients who underwent regular, periodic, and timely follow-up, only 15 cases (27 sides) had polyp recurrence, and the rest were cured; among the patients who did not undergo regular follow-up, 37 cases (57 sides) had nasal adhesions, 26 cases (32 sides) had polyp recurrence, and 31 cases (54 sides) had poor drainage of the sinus passages. Conclusion: Regular, regular and timely postoperative follow-up and cavity cleaning are as important as standardized and thorough surgical operation in patients with chronic rhinosinusitis and nasal polyps who have undergone nasal endoscopic surgery. Yu Guojie, Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University Chronic sinusitis and nasal polyps are common diseases in clinical rhinology, with high incidence in the population and easy to recur after treatment. The main therapeutic measure at present is to adopt active and standardized surgery if conservative treatment is ineffective, but only after close and regular regular review can the good therapeutic purpose be achieved. Now, we summarize 308 cases (530 sides), 266 cases (266/308) of regular and periodic follow-up during surgery and 42 cases (42/308) of patients (42/308) who were not followed up regularly or not followed up after surgery, aiming to understand the importance and necessity of regular follow-up and review after surgery for chronic rhinosinusitis and nasal polyps. 1 General information April 2001 April 2005 the authors collected 308 cases of nasal endoscopic surgery (530 side). There were 198 male cases (365 sides) and 110 female cases (165 sides), with a male-to-female ratio of about 1.5:1; age 12-73 years old, average 39 years old, of which 219 patients (71%) were 20-50 years old. According to the 1997 Haikou standard clinical staging, there were 8 cases of type I stage 1 (13 sides), 36 cases of stage 2 (61 sides), and 45 cases of stage 3 (80 sides); 21 cases of type II stage 1 (36 sides), 58 cases of stage 2 (98 sides), and 62 cases of stage 3 (110 sides); and 78 cases of type III (132 sides). 2 Surgical methods and operating style patients supine head up 30 degrees, routine disinfection of towels, in the nasal endoscopy local anesthesia application of 1% dicaine 20 ml plus epinephrine 8 ml cotton, general anesthesia application of saline 20 ml plus epinephrine 8 ml olfactory fissure, the middle nasal passages, the total nasal tract astringent and – or anesthesia. 308 cases, table anesthesia 237 cases, general anesthesia intubation 71 cases. Sinusitis and nasal polyps were treated according to the range and location indicated by the patients’ sinus coronal and horizontal CT films as surgical indications and guided to surgery, and the surgery was operated by the Messerklinger’s operation, which was performed by opening the maxillary sinus, the anterior and middle sieve sinuses, the whole group of sieve sinuses, and the simple pterygoid sinus, etc., and the surgery was completed by electric suction and cutting device, of which the middle turbinoplasty was done at the same time according to the needs (12 cases), Among them, middle turbinoplasty (12 cases), nasal septum correction (41 cases), partial resection of inferior turbinate (30 cases), opening of frontal sinus (37 cases), and radical surgery of maxillary sinus (102 cases) were performed according to the needs. For non-sinusitis or nasal polyps, extended resection was performed on the basis of Messerklinge’s operation, and the mucous membrane of the sinus cavity was scraped. Postoperatively, the nasal cavity was filled with hemostatic sponges and petroleum jelly gauze. In the postoperative period, those with obvious bleeding were filled with hemostatic sponge, and the rest of the nasal cavity was filled with petroleum jelly gauze, and rehydration and antibiotic treatment were provided. Nasal gauze was withdrawn in the 48th postoperative hour, and the nasal sinuses were rinsed with 500 ml of saline plus 240,000 units of gentamicin or 100 ml of metronidazole, and the nasal cavity was constricted with 1% ephedrine swabs every other day during the hospitalization period, and nasal cavity cleaning was carried out, and the patient was discharged from the hospital in 1 week after the operation. Nasal cleaning was carried out 1 week after discharge from the hospital. Regular postoperative transnasal endoscopic examinations and nasal cleaning were performed once a week during the first month, once every 2 weeks during the first 2 months, and once every 3 weeks during the third to sixth months. Results: According to the 1997 Haikou standard, there were a lot of blood crusts in the nasal cavity in 1-2 weeks after the operation, and there were a lot of crusts, secretions and new granules in the nasal cavity in 2-3 weeks; the secretions and crusts in the nasal cavity fell off in 1 month after the operation, and there were a small number of granules or edematous polyps, and most of the epithelialization of the nasal sinuses was done in 3 months after the operation. There were 266 patients who were followed up regularly (once a week in the first month, once every two weeks in the second month, and once every three weeks in the third to sixth months), and 6 months later, 15 cases (27 sides) showed polyp recurrence after endoscopy, and the remaining 251 cases basically showed a clean lumen without purulent secretion, a good opening of the maxillary sinus orifice, a good opening of the sieve sinus and frontal crypt, and a good epithelialization of the sinus cavities, without polyp recurrence. There was no recurrence of polyps. In 42 patients, due to irregularity of follow-up, some of whom had only one follow-up, or because of unimproved symptoms for a period of time after surgery (often more than one month), nasal adhesions occurred in 37 cases (54 sides), polyp recurrence in &(cases (‘& side), and polyp recurrence in ‘% cases (“!” side). (side) had poor sinus drainage, purulent secretions accumulated in the middle nasal passage, and different degrees of sinus adhesions (between the middle turbinate and the lateral wall, the middle turbinate and the septum, and the inferior turbinate and the septum), all of which recurred 6 months after the operation. Discussion Chronic sinusitis and nasal polyps are common and frequent diseases in clinical rhinology. In the past, the main treatments for patients with chronic sinusitis were conservative treatment with medication and sinus puncture irrigation and replacement therapy, and nasal polyps were resected by the trap method, but in recent years, with the extensive development of nasal endoscopy, the treatment of chronic sinusitis, nasal polyps and other nasal diseases has been improved to a new level, which has significantly reduced the recurrence rate and improved the cure rate. The cure rate has been increased, but the recurrence rate of nasal sinus diseases is easy to recur, so it is not easy to eradicate the disease at one time, and it requires regular and sufficient preoperative preparation, intraoperative treatment and postoperative follow-up to increase the cure rate, otherwise, not only can the primary disease not be cured, but even worse, it will aggravate the harm of the primary disease and increase the occurrence of complications. In this study, only 15 of 266 patients with regular, periodic, and timely follow-up had polyp recurrence (15/266), while all 42 patients without standardized follow-up had recurrence, and the lack of timely and effective postoperative follow-up not only led to the disease not being cured, but also aggravated the original symptoms. With the widespread development of nasal endoscopic surgery, the cure rate of chronic sinusitis and nasal polyps is increasing. Most scholars believe that postoperative follow-up is as important as surgical treatment in terms of therapeutic effect. Through clinical data and observation, we believe that to improve the overall efficacy of nasal endoscopic surgery, i.e., to increase the cure rate, we should pay attention to the following points: good surgical operation techniques, careful operation in place. For the deviation of the nasal septum affecting the operation should be operated at the same time, for the middle and lower turbinate hypertrophy affecting the nasal sinus drainage should be performed at the same time forming or excision surgery, for the maxillary sinus lesions are serious, can still be used to maxillary sinus Cox; land approach surgery; the establishment of a strict postoperative follow-up system, postoperative advice to the patient should be timely to comply with the doctor’s instructions for follow-up, regular, regular, timely cleaning of the operative cavity and make a good record of the review; supplemented with intra-nasal glucocorticosteroids Local administration of glucocorticosteroids plays an important role in the recovery of nasal lesions. Clinical studies have shown that prolonged inflammatory stimulation of the nasal cavity and sinuses leads to a significant proliferation of capillaries in the bone and mucous membranes, an increase in leukocyte infiltration in inflammatory tissues, an increase in the release of inflammatory substances and cytokines. Hormones play a good inhibitory role in these inflammatory mechanisms; patients should have good dietary habits after surgery, such as less spicy food, less smoking, etc. The recovery of nasal mucosal function plays a certain role. In conclusion, although nasal endoscopic surgical technique is an advanced, effective and minimally invasive treatment for sinusitis and nasal polyp diseases, if patients do not have regular, regular and timely postoperative checkups and cleanups after surgery, the therapeutic effect will be doubtful, which emphasizes the importance of postoperative follow-up.