Becker and Cunning have written a balanced review of the available studies on directed endoscopic sinus surgery to relieve frontal and retro-orbital headaches. They conclude that if sinus abnormalities are present on endoscopy or CT (including contact spots), then endoscopic sinus surgery directed toward these abnormalities is more likely to result in headache relief than in the patient without demonstrable sinus or nasal pathologic findings. They caution that the physician's desire to perform endoscopic sinus surgery to help the patient who lacks sinonasal abnormalities must be pursued with the "knowledge that the chances of success are unclear at best."