Cases of chronic disease of the lower respiratory tract attended by purulent sputum in large amounts show an overwhelming incidence of chronic sinus infection. In cases of bronchiectasis, both the incidence and the degree of sinus involvement are higher than in any other group of cases. Of the patients with bronchiectasis studied by Kern and me,1 well over 90 per cent showed roentgen indications and 80 per cent showed clinical evidence of active sinus disease. The average number of sinuses involved per patient is very high, and in most instances there is pansinusitis.
Whether the disease is primary or secondary in patients with bronchiectasis usually cannot be determined. While chronic purulent sinusitis may initiate chronic bronchial infection and bronchiectasis, it is equally possible that the constant spraying of the pharyngeal structures by coughed-up sputum carries infection to the nasal chambers. Thus, purulent pansinusitis has been observed to develop in patients
SCHENCK HP. ETIOLOGY OF BRONCHIECTASIS. Arch Otolaryngol. 1941;34(5):958–965. doi:10.1001/archotol.1941.00660041032007
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