History of surgical approaches to the the frontal sinus

Despite the enormous number of external and endonasal surgical techniques d escribed for the treatment of frontal sinus disease, a single time-proven t echnique has yet to be obtained. The purpose of this article is to critical ly evaluate the lessons of more than a century of endonasal and external pr ocedures. The past has taught us a cautionary lesson for the surgical manag ement of chronic frontal sinus disease, respect for the severity of iatroge nic disease caused by surgical trauma, and the need for long-term follow-up before embracing any new technique to treat this notoriously difficult cli nical problem.