Objective To analyze the effect of sinus balloon catheter dilatation combined with fibrous nasal laryngoscopy on the pain and prognosis of sinus cyst. Methods 85 patients with sinus cysts admitted to our hospital from January 2023 to May 2024 were selected as the study objects. The patients were divided into control group (42 cases) and observation group (43 cases) by random number table method. The control group was treated with conventional endoscopic sinus surgery. The observation group was treated with sinus balloon catheter dilation combined with fiber rhinolaryngoscope. Nasal mucosa status [Lund-Kennedy endoscopic mucosal morphology score], lesion range [Lund-Mackay sinus CT scan lesion range scale], pain degree [NRS] and complication rate of the two groups were analyzed and compared. Results At 8 weeks and 24 weeks after surgery, the Lund-Kennedy scores in both groups were significantly lower than before surgery, and the Lund-Kennedy scores in the observation group were significantly lower than those in the control group at 8 weeks and 24 weeks after surgery (P<0.05). At 24 weeks after surgery, the Lund-Mackay score in both groups was significantly lower than before surgery, and the Lund-Mackay score in the observation group was significantly lower than that in the control group (P<0.05). At 8 weeks and 24 weeks after surgery, the NRS scores of both groups were significantly lower than those before surgery, and the NAS scores of the observation group were significantly lower than those of the control group at 1 week and 4 weeks after surgery (P<0.05). The complication rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion The sinus balloon catheter technique combined with fibernose laryngoscope can improve the status of nasal mucosa, shorten the lesion range, reduce the degree of pain and reduce the incidence of complications.