Chronic rhinitis is currently recognized as a chronic inflammatory state of the nasal mucosa, especially the mucosa of the inferior turbinate. However, there have been many hypotheses about the causative factors and pathogenic mechanisms, which have not been unified. Instead of trying to find out whether there is an inflammatory state in the local mucosal tissues of patients with chronic rhinitis and what the causative factors are that lead to the inflammatory state of the nasal mucosa, it is better to understand what patients with chronic rhinitis are trying to solve! The nasal cavity, as we all know, is the gateway to the respiratory system. Since it is the gateway to the respiratory system, the nasal cavity should be one of the most critical links in the regulation of the entire respiratory system. However, all the literature available at the moment is only a few words about the role of the nasal cavity in the regulation of the respiratory system, and a complete theoretical system cannot be formed. We now know the mechanisms by which the partial pressure of oxygen and carbon dioxide in the blood regulate the respiratory system, and clinical practice confirms that the theoretical system is realistic. Is the respiratory drive only related to chemoreceptors? What is the role of the nasal cavity in the regulation of the respiratory system? In my mind, it is only a vague germ, many details of which I am unable to know. Acute upper respiratory tract infection is experienced by everyone. During the illness, the nose is stuffy and clear watery snot is abundant. Are these two symptoms the ones that give the greatest discomfort? I don’t think so. It is the stuffy headache, swelling, eye swelling, irritability, frustration, and other such feelings that cause the greatest pain to people. What people want to address most is the discomfort they feel from headaches and emotions. Acute upper respiratory infections are short-lived and will eventually pass as a pain. Patients with chronic rhinitis, however, endure a long, painful ordeal. It is natural for them to seek the help of a doctor. But does the doctor really know what the poor man who comes before him wants most to address his symptoms? Does the doctor really know the source of the poor man’s suffering? Does the doctor really know that the chronic inflammatory state of the nasal mucosa is the cause of the poor man’s most painful symptom? Do doctors really know the causative factors of the chronic inflammatory state of the nasal mucosa? Do doctors really know the pathological mechanism of the chronic inflammatory state of the nasal mucosa? Do doctors really know the pathological mechanism of this poor man’s most painful symptom? I believe that the sensation of normal nasal air flow is crucial for the regulation of the human respiratory system and the regulation of human emotions. How can these people maintain their state of existence without a larynx, without the flow of gas through the nose? People without a larynx, because of necessity (laryngeal cancer), have to accept the reality of no transnasal gas flow and have to accept the reality of breathing through a tracheostomy. Although this reality still causes them physical, psychological, and emotional distress, these distress are overshadowed by their greater mental, psychological, and emotional distress: Will the tumor recur? When will it come back? What will be the outcome? In the face of these greater distress, the absence of transnasal gas flow is no longer able to provoke these poor people’s painful feelings. However, chronic rhinitis patients do not suffer from other greater pains, but only from the lack of normal nasal flow, which is their greatest pain! It is very frustrating that these people do not have normal transnasal breathing, which is a small and inherent part of life. Abnormal transnasal breathing is a person’s own feeling and cannot be displayed to others like a physical disability. Nor is it like an abnormal heartbeat that can be shown to others by means of an EKG, ultrasound, CT, etc. This pain, which can only be spoken about, cannot be demonstrated because there is no easy and simple objective examination means to explore it. CFD of nasal gas flow can be demonstrated, but it is costly. The bottom line is, do physicians know what normal transnasal respiratory physiology really is? Doctors focus their attention on the pathogenic factors and pathogenic mechanisms of nasal mucosal inflammation! Doctors do not know that what the poor patient wants is to get rid of the painful symptoms of headache and boredom caused by abnormal transnasal breathing! Can the patient’s most wanted symptoms be solved by simply lowering the nasal resistance and allowing the nasal passages to ventilate? Would it be better to empty the nose to zero nasal resistance? The answer is obviously no. In my opinion, nasal resistance is only an indicator of nasal gas flow and cannot cover the physiological state of normal nasal gas flow. Moreover, nasal resistance is constantly changing due to life scenarios and has a wide range of variation, so it is impossible to discuss the real state of nasal gas flow using this indicator. The human body has evolved the upper, middle and lower turbinates, which must have a physiological significance. What is the physiological significance of these turbinates? What exactly is the role of each in the physiological function of the nasal cavity? How many people have seriously thought about it? With my limited knowledge of nasal gas flow, combined with my clinical experience, I inferred that: the superior turbinates are probably degenerated and have no important physiological function (in a full group of sinusitis patients, the superior turbinates are often removed more than 1/2 due to opening the pterygoid sinus, and the patients have no problems after surgery); the middle turbinates play an important role in transnasal respiratory sensation and olfactory perception, because 60%-80% of nasal airflow flows through the The inferior turbinate plays a leading role in the distribution of nasal airflow and plays a guiding role, not only providing nasal resistance; the inferior and middle turbinates are also the main performers of heating and humidifying the nasal airflow and cleaning and filtering. This is my limited understanding of nasal respiratory physiology that I have worked out on my own, and many details need to be refined, but I believe the general direction is right. I have used this thinking to guide my diagnosis and treatment of non-sinusitis rhinogenic headaches with repeated success. I believe that one of the causes of non-sinusitis rhinogenic headache (another cause is mucosal contact but never compression.) It is the reduced airflow in the middle nasal tract, and increasing the width of the middle nasal tract to improve the airflow in the middle nasal tract can relieve the headache symptoms in these patients. Non-sinusitis rhinogenic headache is particularly likely to occur in adolescents, and these non-sinusitis rhinogenic headache patients are often labeled as “chronic rhinitis” or “chronic rhinosinusitis”. Clinical practice has proved that my speculation is correct in the general direction. If I can continue to explore in this direction, I may find more surprises. I use this idea to know that I treat chronic sinusitis nasal polyps. One patient’s family expressed their gratitude to me, not for the disappearance of sinus inflammation and the absence of recurrence, but for the disappearance of the patient’s postoperative calmness and irritable temper. It shows that normal breathing through the nose is related to one’s mood. One patient even said that after cleaning the hemostatic sponge filled with nasal cavity on the second day after surgery, he was like being in a house on the prairie after the rain, and I was the one who helped him open the window to let him breathe the fresh air of the prairie after the rain. It was amazing how normal nasal breathing, which everyone takes for granted, can be so amazing. This idea is also the basis for my treatment of patients with “Empty Nose Syndrome”. It is true that some patients with “empty nose” have psychological and even spiritual factors. However, it cannot be denied that the nasal breathing of these patients has deviated too far from the normal physiological state (inferior turbinate defect, resulting in 80-90% of airflow through the inferior and common nasal passages and a significant decrease in airflow in the middle and upper nasal passages. The absence of warming, humidifying, cleaning and filtering function of the inferior turbinates and the weakened respiratory sensation of the middle turbinates lead to a series of empty nose syndrome.) , making them unable to compensate for their inability to adapt! Their physiological problems, too, need to be addressed. The direction of the solution is to return them to normal nasal respiratory physiology as much as possible! Is this a direction that every rhinologist is sure to know? Does the disease “chronic rhinitis” exist? Is “chronic rhinitis” only a state of inflammation of the nasal mucosa? Is “chronic rhinitis” only an increase in nasal resistance caused by the inferior turbinates? “What do patients with chronic rhinitis want in the end? It’s time to ask yourself! Once you ask yourself, you will know how to treat “chronic rhinitis”, will there still be “empty nose”?