Frontal Sinus Trephination: Definition & Purpose

Instructor: Sarah Phenix
In this lesson we will explore what a frontal sinus trephination surgery is, why it is used, how it can offer relief to those suffering from severe sinusitis, as well as what a sinus is and its purpose within the body.

What does trephination mean?

A trephination is a hole bored into or through the skull. However, in the case of a frontal sinus trephination, it's a hole bored into the skull through the frontal sinus. Now, of course the obvious follow-up questions are what and where is a frontal sinus and why would anyone elect to have a hole drilled there? Well, let's answer all of these burning questions.

Frontal Sinus Trephination

Now, you may think that a frontal sinus trephination sounds like some form of medieval torture but it's actually a method that offers great relief to people suffering from chronic, or reoccurring, sinusitis, which is an inflammation ('itis') of the sinuses. In fact, anytime you see the suffix 'itis,' you can decode the term as denoting inflammation. For example, arthritis is an inflammation of the joints while tendonitis is an inflammation of the tendons.

So, what does sinusitis feel like? Well, if you've ever been on a plane and your ears wouldn't pop to equalize the pressure in your head then you can certainly sympathize with the extreme pain that sinusitis sufferers feel in their sinuses. Sinusitis is a painful and sometimes debilitating infection of the sinus tissue resulting in inflammation that obstructs the drainage of mucus. Common symptoms include fever, stuffy nose, headaches, and temporary loss of smell and taste. Never fear though, for chronic sufferers whom medication can't help, a frontal sinus trephination can save the day.

Ok, so now that we know that a frontal sinus trephination is a hole bored into the frontal sinus to relieve pressure and drain fluid, let's take a moment to learn what a sinus is and which one is the 'frontal sinus'.

What is a Sinus?

The Four Sinuses within the Skull
Sinuses of the Skull

We actually have four sinuses in our face, each located within the cranial bone they are named for. The frontal sinus is located within the frontal bone of the forehead, the sphenoid sinus and ethmoid sinus are located between the eyes, within the sphenoid and ethmoid bones, while the maxillary sinus is located, you guessed it, in the maxilla bone (upper jaw) on either side of the nose. So why do we have sinuses? Well, a sinus is a tissue-lined, hollow space within the skull that secretes mucus. This mucus drains into the nose and is used both to moisten the air we breathe and to trap particulate in the air, keeping it from entering our lungs. Additionally, the hollow space lightens the weight of our skulls and also aids in sound resonance during speech.

So, now that we know what a frontal sinus trephination is, why it's used, what a sinus is, and which sinus is the frontal sinus, now we can take a moment to explore the surgical procedure itself.

Frontal Sinus Trephination Procedure

Cranial Trephination Hand Tool c.1601-1800
Cranial Trephination Tools c.1601-1800

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