The endoscopic frontal recess approach (Draf type I) procedure is indicated when frontal sinus disease persists despite more conservative endoscopic approaches directed at the infundibulum and anterior ethmoid region. This procedure involves complete removal of the anterior ethmoid cells and uncinate process surrounding the frontal recess to the frontal ostium. Obstructing frontal cells, if present, are removed. The frontal sinus ostium may then drain into a patent frontal recess.