**A Randomized Controlled Study of Paranasal Sinusitis** **Aerosol Therapy (Cefmenoxime + Steroid) vs Oral Resolutional Enzymes** **Kenji Suzuki, MD** Nebulization therapy is widely used in clinical practice for sinusitis due to its safety, convenience, and ability to deliver medication painlessly to multiple paranasal sinuses. However, there is a lack of evidence regarding its efficacy. This study aimed to compare the effectiveness of cefmenoxime (CMX) nebulization therapy with oral resolution enzyme therapy in patients with chronic paranasal sinusitis. A randomized controlled trial was conducted, involving 18 patients receiving CMX nebulization and 15 patients receiving oral resolution enzyme therapy. The clinical efficacy was 77.8% for CMX nebulization and 26.7% for oral resolution enzyme therapy. The cumulative chi-square test showed a statistically significant difference in efficacy between the two groups (p < 0.01). The study highlights the potential advantages of CMX nebulization over oral resolution enzyme therapy, suggesting that it may be a more effective and safer treatment option for chronic paranasal sinusitis. The findings emphasize the need for further research to validate these results and to explore the broader applications of nebulization therapy in otolaryngology. **Keywords:** nasal nebulization therapy, EBM, CMX aerosol therapy vs oral resolution enzyme therapy, randomized controlled study**A Randomized Controlled Study of Paranasal Sinusitis** **Aerosol Therapy (Cefmenoxime + Steroid) vs Oral Resolutional Enzymes** **Kenji Suzuki, MD** Nebulization therapy is widely used in clinical practice for sinusitis due to its safety, convenience, and ability to deliver medication painlessly to multiple paranasal sinuses. However, there is a lack of evidence regarding its efficacy. This study aimed to compare the effectiveness of cefmenoxime (CMX) nebulization therapy with oral resolution enzyme therapy in patients with chronic paranasal sinusitis. A randomized controlled trial was conducted, involving 18 patients receiving CMX nebulization and 15 patients receiving oral resolution enzyme therapy. The clinical efficacy was 77.8% for CMX nebulization and 26.7% for oral resolution enzyme therapy. The cumulative chi-square test showed a statistically significant difference in efficacy between the two groups (p < 0.01). The study highlights the potential advantages of CMX nebulization over oral resolution enzyme therapy, suggesting that it may be a more effective and safer treatment option for chronic paranasal sinusitis. The findings emphasize the need for further research to validate these results and to explore the broader applications of nebulization therapy in otolaryngology. **Keywords:** nasal nebulization therapy, EBM, CMX aerosol therapy vs oral resolution enzyme therapy, randomized controlled study