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Three ports allowed two-hand surgical technique. Results In three laterally pneumatized frontal sinuses of dry skulls, corners, septae, and nasofrontal ducts could be handled using external multiportal endoscopic approach without disruption of anterior frontal wall. Surgical application was done in two cases of frontal sinus mucocele and meningoencephalocele. Outcome parameters were ability to reach corners of frontal sinus, remove sinus septae and nasofrontal duct, and maintain integrity of anterior wall of frontal sinus. Angled endoscopy and standard instrumentation were used reciprocally through different ports to reach different areas of frontal sinus. Additional lateral trephine port beyond midorbital plane was performed. In-situ nondisplaced superiorly based miniosteoplastic flap reaching to midorbital plane was performed providing another port. Classic frontal sinus trephine port was performed initially to safely locate the frontal sinus. Endoscopic external multiportal frontal sinus approach was done using angled endoscopy and standard instrumentation. Feasibility of obliteration of frontal sinus was tested. Three sides were selected with frontal sinus pneumatization extending beyond midorbital line. Materials and methods Ten sides of adult dry skull were assessed for frontal sinus pneumatization and supraorbital cells by computerized tomography. Objective The aim of this study was assess the feasibility and surgical application of this technique for far-lateral pneumatized frontal sinuses. Endoscopic external frontal sinus obliteration is a minimally invasive new technique confined to small-sized and medium-sized pneumatized frontal sinuses. Introduction Osteoplastic flap procedure is a standard method used for frontal sinus obliteration. This is the first report of a minimally-invasive technique for frontal sinus obliteration. The endoscopic approach to frontal sinus obliteration appears to reduce patient morbidity and should be considered in the surgical management of advanced frontal sinus disease. No patients required additional surgery for frontal sinusitis. All 3 surgical complications occurred in the control group. Patients undergoing endoscopic obliteration had less blood loss (P = 0.006), decreased operative time (P = 0.016), and a shorter hospital stay (P = 0.003) compared to osteoplastic control subjects. Thirty-five patients underwent frontal sinus obliteration using either an endoscopic (n=10) or conventional osteoplastic flap (n=25) technique from 1994 to 2004 at an academic medical center. The purpose of this study was to evaluate an endoscopic technique for frontal sinus obliteration. Patients who fail endoscopic drainage procedures for chronic frontal sinusitis often require obliteration of the frontal sinus with abdominal fat.