Frontal sinus surgery is a very common procedure. There are many technologies that are being developed to assist the surgeon in performing this procedure. However, this can cause a false sense of security. Our course describes basic and advanced frontal sinus surgery techniques without the use of navigation systems or computer aids. We discuss navigating without the navigation systems. Key points from our course: 1. Frontal sinus pathology such as mucoceles, chronic sinus disease that failed medical treatment, previous surgery, or neoplasms can lead to complex frontal sinus surgery. 2. Often, key landmarks, such as the uncinate, middle turbinate, and ethmoid bullae, used in sinus surgery are absent or modified during revision sinus surgery. 3. The anterior portion of the natural ostium of the maxillary sinus and the nasolacrimal duct can be used to help guide the surgeon into the frontal sinus recess. 4. During extended frontal sinus surgery, some surgeons advocate opening both frontal sinuses and then connecting the two sides to create one large sinus. However, we have found that opening the “easiest” frontal recess first and then crossing the septum, using the posterior table as a landmark, allows the surgeon to access even the most difficult sinuses. 5. The decision algorithm for the extent of surgery will be discussed based on previous surgery and intra-operative findings. 6. The placement of a frontal sinus stent is controversial, and we will discuss the circumstances when it is needed.