Complication of frontal sinusitis-Not amenable to endoscopic surgery

Endoscopic sinus surgery has brought a change in the concept of treatment of sinus disease. Frontal sinusitis, however, still gives rise to intra and extracranial complication often musked by antibiotic intake. Where endoscopic surgery may fail to completely eradicate disease or even not be feasible due to various anatomic factors and other limitation. It is here that the tried and trusted external approach to the frontal sinus finds a role even today. Four such cases of various complication not amenable to endoscopic sinus surgery are presented here with the view of maintaining the necessity of keeping the external approach within the present day surgical palette when treating complication of frontal sinus disease.