History of surgical approaches to the frontal sinus

Despite the enormous number of external and endonasal surgical techniques described for the treatment of frontal sinus disease, a single time-proven technique has yet to be obtained. The purpose of this article is to critically evaluate the lessons of more than a century of endonasal and external procedures. The past has taught us a cautionary lesson for the surgical management of chronic frontal sinus disease, respect for the severity of iatrogenic disease caused by surgical trauma, and the need for long-term follow-up before embracing any new technique to treat this notoriously difficult clinical problem.