Currently, pituitary tumor surgery through the nasal and pterygoid sinuses is widely performed, but the surgical outcome may vary due to the patient’s condition, each surgeon’s grasp of the condition, and his or her understanding of the technique. In particular, this surgery is performed through the nasal pterygoid sinus, which is a major nuisance to the structure there, and afterwards the pterygoid sinus opening is closed due to the lack of treatment of the pterygoid sinus opening; or fragmented bone is left in the pterygoid sinus during the operation; and after the repair of the skull base with a large amount of relatively blind use of glue and free tissues such as fascia and muscle, these tissues do not heal and grow in the skull base, but become foreign bodies in the pterygoid sinus, causing infection and causing pterygoid sinusitis. Of course, inflammation of other sinuses can also occur due to surgical harassment, but it is often not serious and is often quickly relieved with medication. Zhang Weitian, Department of Otolaryngology, Head and Neck Surgery, Shanghai Sixth People’s Hospital Postoperative pterygoid sinusitis is often directly related to surgical trauma, with relatively large local mucosal trauma, postoperative sinus atresia, and the presence of surgical tissue foreign bodies in the pterygoid sinus, thus often leading to mycosis fungoides. Since the pterygoid sinus is deep and the surrounding anatomy is complex, and the anatomy has been changed due to surgical harassment here, it is difficult to operate again, and the surgeon can easily get lost here, and complications of the skull base and orbital optic nerve can occur extremely easily. We have extensive experience in this area and are reporting a typical case. The patient, a female from Hubei, was 5 years after gamma knife and transnasal butterfly surgery for pituitary tumor removal in a top hospital in Wuhan. Now she has headache and runny nose. She was diagnosed with postoperative pituitary sinusitis in our hospital. In Figure 1, the pterygoid sinus was opened via endoscopy, and the mucous membrane of the pterygoid sinus was seen to be edematous with a large amount of pus crust in the sinus cavity. As in Figure 2 the sinus cavity was also later cleared of fascia that was still free 5 years after surgery (used to repair the skull base that year, but never healed). The patient was discharged healed after surgery as in Figure 3.