IN ALLERGY of the upper respiratory tract the soft tissue of the turbinate body is the primary shock organ. The ethmoid air cells and the maxillary sinuses are the first of the pneumatic cells of the skull to participate in allergic response because they are the air spaces most intimately related to the inferior and the middle turbinate bodies. The frontal sinuses tend to become involved later, and to a lesser degree, because of their less intimate relation to the turbinate bodies. Allergic changes in the soft tissue of the sphenoid sinuses are a comparative rarity because the orifices of these air spaces are still more remote.
The order and degree of allergic involvement of the sinuses can be gaged to some extent by examination of the paranasal sinuses of patients with bronchial asthma.1 A group of these patients showed a high incidence of sinus disease in both a