This presentation aims to provide a comprehensive and evidence-based overview of frontal sinus drain placement, focusing on indications, patient selection, technical nuances, and strategies for minimizing complications. Various drain types, their biomechanical characteristics, technical steps for safe placement, and recommended durations will be discussed in detail. Additionally, the presentation will highlight long-term outcomes from current literature, the role of drains in revision and high-risk cases, and practical considerations that guide decision-making in daily clinical practice.

The session will incorporate high-definition endoscopic images, step-by-step procedural demonstrations, and illustrative case examples. Emphasis will be placed on “technical pearls” that enhance success and common pitfalls that surgeons should avoid. Through the integration of clinical experience and published evidence, the presentation will offer a balanced and practical framework for the use of frontal sinus drains in contemporary rhinologic surgery.

Outcome Objectives:

1. To understand the scientific rationale, indications, and limitations of frontal sinus drain placement.
2. To compare different drain types and placement techniques, with emphasis on their advantages and disadvantages.
3. To recognize postoperative factors contributing to neo-ostium restenosis and to learn evidence-based strategies for its prevention.
4. To evaluate the role of frontal sinus drains in complex, high-risk, and revision frontal sinus surgery.
5. To enable participants to make informed, evidence-based decisions regarding drain placement in their own clinical practice.

Background: Frontal sinus surgery remains one of the most technically demanding areas of endoscopic sinus surgery due to the narrow surgical corridor, anatomical variations, and the dynamic nature of postoperative mucosal healing. Published studies report restenosis rates of the frontal neo-ostium ranging from 20% to 30%, particularly in patients with extensive inflammation, polyposis, or prior surgery. These challenges have prompted increased interest in postoperative strategies aimed at maintaining long-term ostial patency.

Frontal sinus drain placement has become an important adjunctive option, especially in revision cases, patients with a narrow frontal recess, persistent inflammation, scarring, or high risk of mucosal instability. By maintaining lumen caliber during the critical early healing period, drains may reduce the likelihood of closure and support more predictable surgical outcomes. This presentation synthesizes current evidence and clinical experience to clarify the role of drains within modern frontal sinus surgery and to guide surgeons in integrating this technique into their practice when appropriate.