Children have an average of about 6 to 8 colds per year, and about 0.5% to 5% of upper respiratory tract infections are complicated by sinusitis, so children have a higher chance of persistent sinusitis or recurrent sinusitis, which is quite worrying and annoying for parents who are very concerned about their children’s healthy growth, and often ask if there is any good way to cure it at once, or even ask for surgery to achieve rapid and complete treatment. In fact, the onset of sinusitis in children, the onset of the disease, and the onset of the disease in children. In fact, there are some differences between the onset, diagnosis and treatment of sinusitis in children and adults, especially in terms of treatment. Some data show that 40% of acute sinusitis in children can be self-healing, and most children with sinusitis are more sensitive to reasonable medication and may heal naturally during the growth process, but if inappropriate to take too aggressive treatment, such as surgery, it may not only fail to receive the ideal treatment results, and may even lead to abnormal complications of nasal structure, function, and craniofacial development. There are multiple causes of sinusitis in children, or a combination of causes that lead to persistent or recurrent sinusitis. Upper respiratory tract infections are recognized as one of the most common causes, which can lead to colonization and multiplication of Streptococcus pneumoniae, Haemophilus influenzae, and anaerobic bacteria, which can aggravate or recur sinusitis. Secondly, allergic reactions and immune disease factors play a much greater role in the development of sinusitis in children than in adults. Common ones include allergic rhinitis, asthma, and immunodeficiencies (Ig G subgroup deficiency, Ig A or IgM deficiency), all of which can make sinusitis in children more difficult to treat. In recent years adenoids have been more clearly recognized as an important pathogenic factor in childhood sinusitis as well. The overly enlarged adenoids themselves may be a hiding place for bacteria to accumulate and are a major cause of nasal obstruction, retention of nasal secretions, and reduced ciliary activity. Other factors such as nasal polyps, gastroesophageal reflux, and accidental choking can also lead to sinusitis in children. There is a clear pathway for the diagnosis of sinusitis in children, but the details need to be carefully grasped. At present, CT scan is the most routine and valuable means of diagnosing sinusitis, but CT examination of sinusitis in children is best performed after 3 to 4 weeks of antibiotic treatment for acute inflammation to avoid false positives; in addition, sinus opacity on CT films is not necessarily inflammation, and clinicians must combine the child’s clinical presentation with the signs seen on nasal microscopy for diagnosis, because a significant proportion of children with sinus opacity on CT films have neither Recent upper respiratory tract infections nor any nasal symptoms, so no corresponding treatment is needed. The current treatment of sinusitis in children basically follows the stepwise treatment strategy proposed in the United States, which includes the following three standardized treatment steps. The first step is pharmacological treatment. Clinical studies have shown that about 80% of children can be cured by pharmacological treatment, while the remaining 20% may be due to adenoid hypertrophy or other substantial obstructive lesions in the nasal cavity or nasopharynx. Therefore, the second step is to apply non-sinus surgery to remove the cause of nasal obstruction, called endoscopic sinus surgery before surgical intervention, such as adenoidectomy and simple nasal polyp removal, which usually does not open the sinuses, and this treatment can be cured at least 50%. A third step of endoscopic sinus surgery is eventually considered for children who have failed to respond to the previous two steps. Pathological studies have shown that endoscopic sinus surgery has a greater impact on the craniofacial development of children under the age of 9 years, so most scholars are cautious about sinus surgery in children. Indications for surgery should be strictly limited to medically refractory sinusitis, i.e., those in which standardized first and second-step treatments have failed, multiple polyps or severe anatomical abnormalities of the nasal sinuses obstruct nasal sinus ventilation and drainage, or those with asthma. The surgical approach is functional endoscopic sinus surgery, which should be limited as much as possible to the area of the sinus orifice and nasal tract complex, preserving as much mucosa, periosteum and bone as possible, which some experts call the “small hole technique”. Overall, sinusitis in children is not a single disease process and is often associated with other diseases. Medication is preferred for treatment, followed by adenoidectomy, and functional endoscopic sinus surgery is considered only for sinusitis that is difficult to cure with medication.