Abstract: Objective To evaluate clinical outcomes of middle turbinate (MT) in and after endoscopic sinus surgery (ESS). Methods Prospective and non-randomized study in cases before the year 2000 (Group A) and after the year 2010 (Group B), the effect of the two groups with different processing pattern of MT were analyzed. The preoperative patients was evaluated using nasal endoscopy, computed tomography. Objective surgical outcomes were assessed 2 years postoperatively based on endoscopic findings. Results The group B had better objective outcomes. Group A (n = 144) had 12 sides anterior nasal cavity adhesion, including 5 sides severe adhesion, 3sides slight adhesion and occurring in follow-up of 4 sides, after treatment were followed up for 6 months, four sides still had nasal cavity adhesion. Group B (n = 152) had 2 sides slight anterior nasal cavity adhesion. Conclusion The sub-mucoperiosteal surgery as the main of the diversification of middle conchoplasty, could retain more middle turbinate mucosa and its function; Out of anoperation mode, the middle conchoplasty extended to the mode of three-steps surgery+packing+cleaning, as well as the cocktail mode of postoperative packing and cleaning, and could be solved with the problem of middle turbinate resection or preservation.