Recently, Director Qiu Qianhui of the Department of Otolaryngology consulted a special case. From the moment he entered the ward, Director Qiu found the female patient curled up on the bed with her head in her arms and a painful expression. After a detailed understanding of her condition, she was told that she was 58 years old and had a headache 4 months ago, with no fever, no physical weakness or other obvious causes. The patient went to several hospitals, and after several examinations, no definite diagnosis was made, and only pain relief treatment was given, but the condition returned. Later, after many inquiries, he was referred to our hospital. After the patient was admitted, after nasopharyngeal and skull base enhancement MR examination, the results showed that there was an abnormal signal shadow in the cavernous sinus apices of the right skull base, suggesting a lesion in this region, and Director Qiu initially determined that it was a chronic inflammatory lesion with inflammatory foci in the right pterygoid sinus and mastoid process. After discussion, the team decided to perform endoscopic nasocranial base surgery on the patient, and the chief surgeon was Director Qiu Qianhui. The operation was performed through the right nasal approach, opening the posterior group of septal and pterygoid sinuses, and revealed more brown fungal masses in the pterygoid sinus, and the mucosa of the pterygoid cavity was swollen and brittle, which confirmed the preoperative diagnosis of Director Qiu. The inflammatory necrotic tissue had eroded the bony canal of the right internal carotid artery, resulting in a bone defect in the pterygoid segment of the right internal carotid artery and the artery was exposed in the pterygoid sinus cavity, and the inflammation also entered the cavernous sinus from the posterior superior internal carotid artery. In addition to removing the lesion in the pterygoid sinus, the operation was performed to remove the lesion by bypassing the posterior superior part of the internal carotid artery into the cavernous sinus and finally repairing the wall of the exposed segment of the internal carotid artery. The surgical procedure went smoothly, and the postoperative pathology showed chronic inflammation of the mucosa of the right pterygoid sinus and cavernous sinus, which was a varicella infection. On the second day after the operation, the patient told the doctor that although there was still stuffing in the nasal cavity, the headache was less severe than before the operation and he did not have to curl up in the hospital bed with his head in his arms all day. When the nasal stuffing was removed, the patient felt relieved and said that he had not slept and eaten so well for a long time. When the patient was discharged from the hospital, the ENT doctor instructed her to continue intravenous antifungal medication at the local hospital for six months.