Frontal sinus stenting techniques

Postoperative reocclusion or obstruction of the frontal sinus outflow tract are key factors in the failure of surgical efforts to treat frontal sinus disease. Stenting of the frontal sinus is a useful adjunctive measure for select patients, including those who have failed previous surgical treatment or who are deemed to be at high risk of failure due to unfavorable anatomy or mucosal disease. Multiple approaches to stenting of the frontal sinus are available, including purely endonasal techniques, a combined approach using both endonasal access to the frontal sinus and external trephination, and an external approach via modified Lynch (Neel-Lake) frontoethmoidectomy. Herein, we describe the surgical techniques for frontal sinus stent placement, review the options for choice of stenting material, and discuss key factors in postoperative management and stent maintenance.