The role of mini-trephination in the management of frontal sinusitis.

The surgical management of chronic frontal sinusitis remains an area of controversy. Since the introduction of endoscopic sinus surgery, many novel approaches to this difficult problem have been developed. Recently at the University of Virginia, mini-trephination of the frontal sinus has been used in combination with endoscopic frontal sinusotomy. This technique has enabled confident and precise identification of the frontal sinus ostium, culture of sinus contents, and irrigation of the frontal sinus. A retrospective review of 22 minitrephinations since November 1997 was performed. The short term results are encouraging with a frontal sinus patency rate of 90%; however, long-term follow-up is required. We conclude that the technique is reliable and reproducible.