Frontal sinus surgery is performed either through an incision by the eyebrow and can be combined with the ethmoid surgery. Occasionally, the surgeon will leave a drain in this area for 24 - 72 hours, or longer. If the frontal sinus disease is bad enough or the scarring from the disease or previous
surgery is obstructive of this area, the surgeon may need to drill out the frontal duct or leave a stent in this area. This procedure
combined with an external ethmoidectomy is called a Lynch procedure (frontoethmoidectomy).
For severe disease in the frontal sinus, including a particularly aggressive mucocele, an osteoplastic flap with fat obliteration may need to be performed. This entails an incision across the hair line, where the skin and soft tissues of the forehead are then totally dropped down. The surgeon then can open the frontal sinus, and with fat taken from the abdominal wall, can pack the frontal sinus, thereby obliterating it. Stitches are placed in the forehead to close the incision site and a scar usually remains, which is especially noticeable if you are balding.
There is usually significant swelling and black-and-blue marks to the forehead and around the eyes which usually resolve over a few weeks. Unfortunately, this type of surgery usually means significant blood loss, requires a hospital stay, packing, and general anesthesia.