Crocetta FM, Farneti P, Sollini G, et al. - In this study, frontal sinus complications developed after previous external craniotomies requiring frontal sinus reconstruction and their management with an endoscopic approach were evaluated. Researchers here retrospectively evaluated 22 patients who presented with frontal sinus disease after frontal craniotomy with sinus reconstruction performed to manage various pathological conditions; these comprised in total, 14 frontal mucoceles, 4 cases of chronic frontal sinusitis, 2 mucopyoceles and 2 fungus ball of the frontal sinus. Observations suggest that following craniotomies, patients can develop frontal sinusopathy as a long-term complication which may result in potentially severe pathological conditions, such as mucoceles and frontal sinus inflammation. Controversies remains concerning its management. This study confirms the possible utility of the endoscopic endonasal approach as a valid solution with low morbidity avoiding re-opening of the craniotomic access. In selected cases, simultaneously undertaking endoscopic approach with craniotomy as a combined surgery may decrease the risk of short- and long-term complications. It is mandatory to undertake long-term follow-up in patients with a history of opened and reconstructed frontal sinus, with inclusion of imaging and endoscopic outpatient evaluation.