INFECTIONS of the accessory nasal sinuses are frequently associated with asthma. There is a wide range of infection. In some patients the sinuses are normal, but in others the lining membranes show polypoid degeneration and are often invaded by saprophytic bacteria. While these sinus infections may precede the onset of asthma, if there be an associated bacterial rhinitis, infection may develop insidiously as the disease progresses and becomes chronic. However, in certain instances rhinitis, subacute sinusitis, and symptoms of asthma develop almost simultaneously. In this group of patients, after bacterial inoculations have been started, frequently the antral openings have been permanently enlarged by intranasal antrotomy because irrigation has been difficult and drainage inadequate. Under these conditions the effect of bacterial therapy on the course of these subacute antral infections could be observed directly.
In patients with "atrophic" nasopharyngeal symptoms the nasal mucosae may be sensitized to the common respiratory bacteria.