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In a previous critical study of the surgical management of cases of definite suppurative frontal sinusitis with some external manifestation, it was found that the best results were obtained by employing the two-stage, intranasal and radical operation. Further experience with the same type of disease has shown that the two-stage operation is satisfactory. The external radical stage may be avoided in certain cases in which it might have suggested itself primarily as the method of choice.
The rationale of the method seems reasonable. It was observed that the intranasal maneuver as the final stage in the external radical operation presented many difficulties; for example, the anatomic relations are inverted; bleeding interferes notably with good visibility; and in case other paranasal sinuses are involved, too radically destructive measures are required to eradicate the disease. The intranasal stage of the operation, on the other hand, performed under local anesthesia