In recent years, the application of high-flow nasal cannula (HFNC) in clinical anesthesia has become increasingly widespread. Its feasibility, effectiveness, and safety in perioperative oxygen therapy have been progressively confirmed and recognized. This technology has demonstrated significant advancements and innovations in airway management within anesthesia, particularly in addressing difficult airways. Patients undergoing eye and ear-nose-throat (ENT) surgeries frequently present with difficult airways, imposing higher demands on airway management techniques. However, there remains a lack of clear evidence-based guidelines and structured recommendations regarding the application of HFNC in ENT anesthesia airway management. Based on relevant research progress both domestically and internationally, as well as Chinese clinical practice, the Otorhinolaryngology Anesthesiology Group of the Chinese Society of Anesthesiology organized an expert team to formulate this consensus. The consensus systematically elaborates on the physiological mechanisms, applicable scenarios, and specific operational methods of HFNC, from theory to practice. It covers multiple aspects, including the induction phase, intraoperative non-intubated anesthesia management, postoperative extubation oxygen therapy, and applications in special populations. Addressing different clinical needs, the consensus clearly outlines the recommendations, contraindications, and precautions for HFNC, further standardizing its application in ENT anesthesia airway management and providing an evidence-based framework for optimizing perioperative airway management. This consensus aims to promote the standardized application of HFNC technology in ENT anesthesia, improve patient safety, and provide theoretical support and practical guidance for future clinical research and technological advancements.