There are two basic surgical approaches to nasal endoscopy, the Messerklinger technique (anterior to posterior) and the Wigand technique (posterior to anterior); both have their advantages and disadvantages. The surgeon can choose or adapt the procedure according to the lesion, the characteristics of different procedures and his or her own habits. 1.Procedure and advantages and disadvantages of the Messerklinger procedure: Procedure: incision at the anterior border of the hook; resection of the hook; septal vesicle resection and removal of the anterior septal lesion; opening or enlargement of the frontal sinus and maxillary sinus opening; removal of the posterior septal lesion; opening or enlargement of the pterygoid sinus opening and removal of the intra-sinus lesion. Advantages: (1) The operation is performed from superficial to deep, in accordance with the general surgical practice; (2) The operation starts from the site with lesions and the scope of the operation can be decided flexibly by removing the lesions as needed. (3) Disadvantage: In order to expose the posterior septal sinus or the pterygoid sinus, it is necessary to remove the hook and anterior septal structures first. 2.Procedure and advantages and disadvantages of the Wigand procedure: Surgical procedure: excision of the posterior segment of the middle turbinate; opening and enlargement of the anterior wall of the pterygoid sinus; removal of the lesions of the posterior and anterior groups of the septum from posterior to anterior, using the superior and lateral walls of the pterygoid sinus as markers; opening or enlargement of the opening of the frontal and maxillary sinuses. Advantages: (1) Direct opening of the pterygoid sinus is most suitable for surgery of the pterygoid sinus lesion alone or the pterygoid saddle; it is also suitable for surgery of the posterior sieve with mild anterior sieve lesions or combined pterygoid sinus lesions; (2) The integrity of the anterior sieve sinus anatomical landmarks such as the middle turbinate is less required, which is helpful for those whose anterior sieve anatomical landmarks have been destroyed by previous surgery and can reduce the risk of complications caused by surgery. Disadvantages: (1) the procedure is not in accordance with the surgical custom from deep to superficial; (2) the posterior segment of the middle turbinate needs to be removed, which has a certain impact on the physiological function of the nasal cavity; (3) a more spacious nasal cavity is required to ensure sufficient operating space in the surgical cavity; the type of surgery and the surgical approach should be decided preoperatively based on the medical history, nasal endoscopy and CT scan. For example, in cases with polyp-like changes at the posterior end of the middle turbinate or polyps in the pterygoid sinus, while there are no lesions or very mild lesions in the hooks and anterior group of septal sinuses, the posterior-to-posterior surgery can be used; sometimes, the middle turbinate has been completely removed in the previous surgery and no clear traces can be found, so in order to prevent damage to important structures such as the sieve plate and the roof of the frontal saphenous fossa due to the lack of signs during surgery, the posterior-to-posterior surgery can be used; in cases with normal posterior end of the middle turbinate or no lesions in the pterygoid sinus In order to preserve the normal structure, it is appropriate to adopt the anterior to posterior surgical style. Since most of the sinus lesions are mainly in the anterior septum and sinus orifice nasal tract complex, the Messerklinger procedure is adopted in most clinical cases. In conclusion, the choice of surgical style is based on the principles of reducing injury, convenient operation, safety and efficiency. Based on good preoperative CT photographs, a realistic design of the type and manner of surgery can usually be made preoperatively. Even so, the established surgical procedure should not be adhered to during surgery, and the decision can be made flexibly based on a thorough understanding of the medical history, clinical manifestations and intraoperative views. In a few severe and complex nasal lesions, an external nasal approach is still necessary. According to our experience, with the accumulation of experience and the gradual mastery of operating skills, the treatment of inflammatory nasal lesions rarely needs to be supplemented by external nasal approach surgery.