Purpose <p>There has been concern regarding the applicability of the Carolyn’s Window Approach (CWA) to Asian patients because the nasal corridors in Asians are typically narrower externally with lower radix height compared to Western noses. This study evaluated the success rates and frontal sinus patency outcomes of the CWA in a cohort of Asian patients.</p> Methods <p>Patients (≥ 18 years) who underwent frontal sinus surgery via CWA were consecutively enrolled. Patients were followed at 3 and 6 months after surgery. Anthropometric data on nasal appearance were obtained from CT scans. The outcomes were the success rate and the patency of the frontal sinus, determined by the ability to endoscopically visualize the frontal sinus at 3 and 6 months postoperatively.</p> Results <p>A total of 51 frontal sinuses (41 patients) were included. The ratios of nasal length to tip projection, dorsal height, and radix height were 2.00:0.82:0.49:0.24. All frontal sinus surgeries were successfully performed via the CWA using a 0° endoscope, with visualization of the sinus achieved in all cases. At the 3-month postoperative follow-up, 48 frontal sinuses (94.1%) remained patent. At 6 months, patency was maintained in 44 frontal sinuses (86.3%).</p> Conclusion <p>The CWA is a feasible and effective technique for frontal sinus surgery in Asian patients, achieving patency rates of 94.1% at 3 months and 86.3% at 6 months.</p> Registration <p>Thai Clinical Trial Registry, TCTR20230802002, on August 2^nd, 2023.</p>