Inflammatory disease of the nose and sinuses is noninfectious and infectious in origin.
Wittmaack has shown that noninfectious irritants change the character of the young aural mucosa and make it more susceptible to chronic infection. His outstanding contribution to pathology has failed to recognize allergy, which is perhaps the most important irritative influence.
Edema is the chief characteristic of allergic inflammation. By its action the fibers of the submucosa are separated and floated apart. Immediate swelling of the tissue results, more marked in infantile mucosa, which still retains the embryonic reticular arrangement of its fibers. The immediate swelling of the tissues may be considerable. However, it has been exaggerated to explain the evanescent shadows on the x-ray film. It is obviously impossible for normal mucosa, which is as thin as cigaret paper, to become 1 or 2 cc. thick without the time element essential for hypertrophy of tissue.
SEWALL EC. SINUSITIS ALLERGY AND THE COMMON COLDA CONCEPTION OF THEIR RELATIONSHIP. Arch Otolaryngol. 1935;22(4):425–434. doi:10.1001/archotol.1935.00640030441004
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