a. Preoperative sinus CT, the patient had left-sided headache, double nasal congestion and nasal polyps b. Part of the middle turbinate base plate was preserved during the operation c. 3 months after the operation, the symptoms were basically eliminated, endoscopic review showed no outward displacement of the middle turbinate, no narrowing and adhesions in the middle nasal passage, smooth drainage in all nasal passages, and gradual epithelialization of the trabecular surface d. 6 months after the operation, there was no headache and nasal congestion, endoscopic review showed no outward displacement of the middle turbinate, no narrowing and adhesions in the middle nasal passage, smooth drainage in all nasal passages e. 12 months after surgery. No headache and nasal congestion, endoscopic review, the drainage of each sinus is satisfactory, the efficacy of the treatment is stable Nasal endoscopic surgery after the middle turbinate external displacement, the middle tract stenosis or adhesion is the chronic sinusitis nasal polyp patients nasal endoscopic surgery is one of the most common complications of endoscopic surgery, how to avoid the occurrence of the above situation, to improve the efficacy of the nasal endoscopic surgery is the otorhinolaryngologists and the majority of patients with the common concern. From our own surgical experience, we adopted an improved surgical approach and received good results. In the Messerklinger’s procedure, which is commonly used nowadays, the conventional method of dealing with the middle turbinate base plate and posterior sieve sinus is to penetrate the inner lower part of the middle turbinate base plate with sieve sinus forceps of different angles, and open the posterior sieve sinus up to the anterior wall of pterygoid sinus by going backward along the outer side of the middle turbinate root, and then removing the orbital paper plate and the residual airspace of the middle turbinate root and the anterior wall of the pterygoid sinus from the anterior to posterior or posterior to anterior in a sequential manner. Among them, the preservation of the bony framework structure at the level of the middle turbinate baseplate was not particularly emphasized, and the stability of the middle turbinate often declined and drifted laterally after surgery, causing the middle turbinate to adhere to the lateral wall of the nasal cavity, which became the most frequent complication after FESS surgery, with an incidence ranging from 1.2% to 43%. Adhesion of the middle turbinate to the lateral wall of the nasal cavity severely affects the efficacy of nasal endoscopic surgery and sometimes requires further surgical management. In order to maintain the stability of the middle turbinate and prevent the adhesion between the middle turbinate and the lateral wall of the nasal cavity, many efforts have been made by scholars at home and abroad.Thornton applied the suture technique to suture the middle turbinate to the nasal septum bilaterally to maintain the stability of the middle turbinate, to prevent the adhesion of the middle tract and to preserve the middle turbinate. However, this is difficult to perform in a narrow nasal cavity, and it is also difficult to pass the needle through the middle turbinate and the bony portion of the septum, especially when septoplasty is not performed at the same time, and the simultaneous operation can be traumatic in a narrow nasal cavity, which has prevented the technique from being widely promoted in the clinic. Some advocate regular postoperative dressing changes to remove vesicles and adhesions, while others advocate placing a tumescent sponge in the nasolacrimal tract for a longer period of time, which can cause discomfort to the patient and obstruct nasal and sinus ventilation.Moukarzel applies a special clip to the anterior portion of the middle turbinate to the corresponding septal mucosal flap, which carries the risk of premature detachment of the clip, outward movement of the middle turbinate, inadvertent suction of the clip, and adhesion of the middle turbinate to the septum. Gall et al. and Lee et al. designed a silicone film to be attached to the middle turbinate to reduce the incidence of adhesions in the middle nasal passage, but it is easy to be dislocated or discharged in the postoperative period, and prolonged fixation of the silicone film in the middle nasal passage is prone to infections and even fatal toxic shock syndrome. Lately, HA-CMC has also been used to prevent adhesions, but the effectiveness of these materials remains unclear. Bolger et al. and Friedman et al. adhered the middle turbinate to the septal surface in anterior group sieve sinus openings and anterior-posterior group sieve sinus openings using the controlled adhesion technique (formation of a fresh wound on the septal surface of the middle turbinate and on the opposing septal surface of the turbinate with a cutter), which sometimes interferes with the functioning of olfaction, and sometimes adhesions do not always form. Although there are different methods aimed at preventing the formation of adhesions on the lateral aspect of the middle turbinate, each method has certain drawbacks and/or difficulties, and there is no standardized procedure that is widely accepted. In fact, it is feasible to avoid the occurrence of middle turbinate instability and drift by careful and prudent surgical techniques. The anatomy of the middle turbinate allows for the careful preservation of the horizontal bony framework structures, such as the anterior-superior portion of the middle turbinate attached to the turbinate region and the inferior-posterior portion of the middle turbinate plate, and the preservation of these structures is of great importance in maintaining the stability of the middle turbinate postoperatively, and preventing the external migration of the middle turbinate from adhering to the posterolateral wall of the nasal cavity. We started from the preservation of the horizontal bony framework structure of the middle turbinate itself, and tried to maintain the integrity of these horizontal bony structures under the premise of ensuring the complete removal of the lesion, which proved to be feasible in practice, and the improvement of the patient’s voluntary symptoms was obvious after the operation. In the medium and long term (>3 months), such an operation reduces the tendency of the middle turbinate to move outward due to scar contraction, which can better maintain the stability of the middle turbinate, and the incidence of adhesions in the middle nasal passage is greatly reduced, which better ensures the long-term efficacy and significantly improves the efficacy of endoscopic sinus surgery. Moreover, this method does not require special materials for preparation, eliminating the possibility of complications due to these special materials and reducing the burden on the patient. At the same time, this method also follows the principles of minimally invasive and anatomical function preservation, making endoscopic sinus surgery more delicate and minimally invasive.