This article was published in full in the Journal of Otolaryngology-Head and Neck Surgery, Vol. 7, No. 1, 2000. 11 years have passed, our diagnostic and therapeutic techniques and methods have been improved, and all surgeries have been performed using minimally invasive nasal endoscopic surgery, and the traditional curvilinear maxillary sinus radical surgery has long been abandoned. However, the overall pathogenesis of mycosis fungoides is basically similar to the one I have published in this article. Maxillary sinus mycobacteria are more likely to occur in the elderly, in women, in diabetic patients, and in patients with heavy use of broad-spectrum antibiotics and immunosuppressive drugs. As scientific knowledge, I hope this information will be of some help. The following is an overview: Since Plaignus reported the first case of fungal sinusitis in a human in 1791, the number of reported cases of fungal sinusitis has gradually increased with the continuous improvement of diagnostic techniques. We analyzed the incidence of maxillary sinus fungal disease in patients who underwent radical maxillary sinus surgery at our hospital during the 5-year periods from 1984 to 1988 and 1994 to 1998, and discussed the trends in the incidence of this disease in the hope of improving the understanding of this disease. From 1984 to 1988, fungal maxillary sinusitis cases accounted for 15.79% of maxillary sinus radical surgery cases, with a sex ratio of male:female = 1:2, and a mean age of 60.5 years for males and 54.25 years for females. = The mean age of males was 51.33 years and that of females was 47.5 years. However, the difference between the two age groups was not statistically significant by x 2 test (P > 0.05). Male to female ratio: The common feature of both groups was that there were significantly more female patients than male patients, with a male to female ratio of 1:2 and 1:2.33, respectively, suggesting a relationship between the onset of maxillary sinus fungal disease and gender. It has been reported in the literature that the non-invasive type, especially the fungal bulb type, is more likely to occur in female patients. Endocrine changes, especially changes in estrogen levels, may trigger or exacerbate fungal maxillary sinusitis, but there is a lack of sufficient information to explain this feature. Further investigation of this issue will help to improve understanding and management of this disease. Age: Comparing the age characteristics of the two 5-year data, three things can be suggested: ① The mean age of both groups was older, ranging from 47.5 to 60.5 years for both sexes, and foreign literature also reports that sinus fungal disease generally occurs in older patients. This feature may be related to the physiopathological characteristics of middle-aged and elderly patients, such as decreased body resistance, weakened immune function and the possibility of multiple chronic diseases such as diabetes mellitus. ② In both groups, male patients were older than female patients, with a mean age difference of 6.25 and 3.83 years, respectively. This suggests that the female patients were younger than the male patients to some extent. ③ Compared with the period 1984-1988, the age of both male and female patients decreased significantly from 1994 to 1998, with a mean age decrease of 9.17 years for males and 8.83 years for females. The reasons for these characteristics may reflect a trend in the incidence of fungal maxillary sinusitis, but may also be related to the influence of random error in the limited sample size. Incidence rate: Compared with the period 1984-1988, the proportion of fungal maxillary sinusitis in radical maxillary sinus surgery increased significantly between 1994 and 1998, by approximately 81%. The reasons for this change may be related to the following factors: ① Improvement in the level of diagnosis: Due to the increasing awareness and attention of clinicians to these diseases, the continuous improvement of pathological diagnosis techniques and the continuous development of imaging techniques such as CT, the lesion site was found by imaging data in cases that could not be diagnosed by repeated clinical examination. In our clinical work, we found that patients with long-term nasal discharge with no lesion found were finally found to have sinus fungal disease after sinus X-ray or CT examination. Cases that may have been diagnosed as caseous maxillary sinusitis are now classified as fungal maxillary sinusitis due to pathological confirmation. Thus, clinicians may feel that the incidence of fungal maxillary sinusitis is increasing, and in fact this increase may be due in part to an increase in the level of diagnosis. (2) Influence of drugs: The long-term use, inappropriate use and abuse of antibiotics, especially broad-spectrum antibiotics, may lead to dysbiosis in many parts of the body, including the nasal cavity and sinuses, and may trigger fungal infections. In addition, the use of immunosuppressants and corticosteroids is also a possible cause. It is worth noting that fungal infections, especially secondary fungal infections, are closely related to chronic diseases such as diabetes mellitus. With the improvement of living standard, the incidence of diabetes mellitus is also increasing. However, no evidence of abnormal blood glucose or immune deficiency was found in our data. The extent to which the increased incidence of fungal maxillary sinusitis is related to this deserves further study.