Abstract
Background: Chronic frontal rhinosinusitis (CFRS) is a condition in which there is a persistent frontonasal outflow tract obstruction that leads to impairment of the normal drainage. Frontal sinus surgery is known to be a challenging surgery due to the complex frontal sinus anatomy, which is considered to have many anatomical variations from one patient to another. Objective: To present the different causes, diagnostic, and management plans to different frontal sinus pathologies in order to provide the best management strategies. Methods: This is a retrospective clinical study, which was conducted between 2010 to 2019. The study was conducted in the ENT department of King Fahad specialist Hospital in Saudi Arabia. It included only the patients with sole involvement of the frontal sinus managed endoscopically. Results: A total of 450 endoscopic sinus and skull-base procedures were performed at King Fahad Specialist Hospital-Dammam in the period from 2010 to 2019. Out of the total number of cases, 51.3% (231) of the cases fulfilled the criteria of endoscopic frontal sinus surgery. Conclusion: With the advantages of the state of art imaging, different angeled endoscopes and intraoperative image guidance system, the different endoscopic approaches to different pathologies of the frontal sinus will result in a wide frontal outflow tract and a safe outcome while minimizing the need for the external approach to the frontal sinus with its morbidities and hence improves the patient's quality of life.