Current concepts in the surgical management of chronic frontal sinusitis

The surgical management of chronic frontal sinusitis has lagged behind that of other sinuses because of a relative infrequency of the disease, the difficulty in diagnosing it, the anatomical complexity of the area involved, an inadequate understanding of the airflow and mucus drainage pathways, the complexity and lack of success of surgical procedures, and the need for advanced equipment. A review of the anatomy, embryology, and physiology of the nasofrontal region is given followed by a summary of the signs, symptoms, and radiologic findings of chronic frontal disease because often the most difficult decision is knowing when to intervene surgically. Finally, there is a discussion of current techniques and recent advances using powered instrumentation in the nasofrontal area.