Diseases of the nasal accessory sinuses, it would seem, are becoming more frequent, and the maxillary sinus is most frequently invaded because of its size and anatomic characteristics of development. There is no doubt that mechanical deviation from the normal in development has some influence on the ultimate welfare of the maxillary sinus, and I am of the opinion that these mechanical changes, beginning early in life, offer hindrances and present a favorable background when invasion of the maxillary sinus occurs.
This, combined with an excessive or improper blowing of the nose while an acute rhinitis or an infection of the upper respiratory tract is present, justifies the assumption that there is a mechanical influence in the etiology of a disease of the maxillary sinus. Also, it is logical to assume that in those cases in which a spontaneous recovery of an acute infection of the sinus takes place, the