A paranasal sinus access implant device (500, 510, 630, 700, 800, 800', 800", 800"', 860, 860', 860", 860"', 860"", 884, 884', 892) useful for implantation in a human to fluidly connect a lacrimal apparatus to a paranasal sinus through a fistula formed between the lacrimal apparatus and the paranasal sinus, the implant device (500, 510, 630, 700, 800, 800', 800", 800"', 860, 860', 860", 860"', 860"", 884, 884', 892) comprising: a proximal end (522, 716, 816) at a first longitudinal end of the device to be disposed in the lacrimal apparatus when the device is implanted and a distal end (524, 634, 718, 818) at a second longitudinal end of the device to be disposed in the paranasal sinus when the device is implanted; a length longitudinally along the implant device (500, 510, 630, 700, 800, 800', 800", 800'", 860, 860', 860", 860'", 860"", 884, 884', 892) between the proximal end (522, 716, 816) and the distal end (524, 634, 718, 818) in a range of from 8 millimeters to 50 millimeters; a conduit (504, 514, 704, 804, 804', 804"', 864, 864', 864", 888, 896), located between the proximal end (522, 716, 816) and distal end (524, 634, 718, 818), to be disposed through a fistula between the lacrimal apparatus and the paranasal sinus when the device is implanted, the conduit (504, 514, 704, 804, 804', 804'", 864, 864', 864", 888, 896) comprising a distal portion to be disposed in the paranasal sinus when the implant device (500, 510, 630, 700, 800, 800', 800", 800'", 860, 860', 860", 860'", 860"", 884, 884', 892) is implanted; a head (304, 502, 512, 632, 702, 802, 802", 802"', 862, 862', 862", 862"', 886, 894) located proximal of the conduit (504, 514, 704, 804, 804', 804'", 864, 864', 864", 888, 896), to be disposed in the lacrimal apparatus when the device is implanted; an internal passage (526, 738, 838, 890, 890', 897) through the head (304, 502, 512, 632, 702, 802, 802", 802'", 862, 862', 862", 862'", 886, 894) and the conduit (504, 514, 704, 804, 804', 804"', 864, 864', 864", 888, 896), to provide a fluid communication path between the lacrimal apparatus and the paranasal sinus when the device is implanted, the internal passage (526, 738, 838, 890, 890', 897) having a width (740, 840) through at least a portion of the conduit (504, 514, 704, 804, 804', 804'", 864, 864', 864", 888, 896) in a range of from 0.25 millimeter to 5 millimeters; and characterized in that: at least one of the head (304, 502, 512, 632, 702, 802, 802", 802"', 862, 862', 862", 862'", 886, 894) and the distal portion of the conduit (504, 514, 704, 804, 804', 804"', 864, 864', 864", 888, 896) comprises an exposed surface over a continuous surface area of at least 2 square millimeters of exposed material, the exposed surface having an average roughness (Ra) of not larger than 200 nanometers. a proximal end (522, 716, 816) at a first longitudinal end of the device to be disposed in the lacrimal apparatus when the device is implanted and a distal end (524, 634, 718, 818) at a second longitudinal end of the device to be disposed in the paranasal sinus when the device is implanted; a length longitudinally along the implant device (500, 510, 630, 700, 800, 800', 800", 800'", 860, 860', 860", 860'", 860"", 884, 884', 892) between the proximal end (522, 716, 816) and the distal end (524, 634, 718, 818) in a range of from 8 millimeters to 50 millimeters; a conduit (504, 514, 704, 804, 804', 804"', 864, 864', 864", 888, 896), located between the proximal end (522, 716, 816) and distal end (524, 634, 718, 818), to be disposed through a fistula between the lacrimal apparatus and the paranasal sinus when the device is implanted, the conduit (504, 514, 704, 804, 804', 804'", 864, 864', 864", 888, 896) comprising a distal portion to be disposed in the paranasal sinus when the implant device (500, 510, 630, 700, 800, 800', 800", 800'", 860, 860', 860", 860'", 860"", 884, 884', 892) is implanted; a head (304, 502, 512, 632, 702, 802, 802", 802"', 862, 862', 862", 862"', 886, 894) located proximal of the conduit (504, 514, 704, 804, 804', 804'", 864, 864', 864", 888, 896), to be disposed in the lacrimal apparatus when the device is implanted; an internal passage (526, 738, 838, 890, 890', 897) through the head (304, 502, 512, 632, 702, 802, 802", 802'", 862, 862', 862", 862'", 886, 894) and the conduit (504, 514, 704, 804, 804', 804"', 864, 864', 864", 888, 896), to provide a fluid communication path between the lacrimal apparatus and the paranasal sinus when the device is implanted, the internal passage (526, 738, 838, 890, 890', 897) having a width (740, 840) through at least a portion of the conduit (504, 514, 704, 804, 804', 804'", 864, 864', 864", 888, 896) in a range of from 0.25 millimeter to 5 millimeters; and characterized in that: at least one of the head (304, 502, 512, 632, 702, 802, 802", 802"', 862, 862', 862", 862'", 886, 894) and the distal portion of the conduit (504, 514, 704, 804, 804', 804"', 864, 864', 864", 888, 896) comprises an exposed surface over a continuous surface area of at least 2 square millimeters of exposed material, the exposed surface having an average roughness (Ra) of not larger than 200 nanometers.