Evidence of trephination has been seen through the analysis of excavated skulls. Frontal sinus trephination also enhances the visualization in anatomy. As many as five main methods were found for trephination. Cranioplasty was closely related to trephination and the earliest operation is dated to 3000 BC. For trephination, the block is often more painful than the procedure. Trephination of frontal sinus is a safe procedure though precautions should be taken.