A comparison of mucous gland size in the bronchial and nasal mucosa was performed on material from 24 random necropsies. The Reid index and counts of mucous gland acini were used as measures of hypertrophy. In 14 of these cases the relationship between goblet cell hyperplasia in the sinus mucosa and the presence of chronic bronchitis was investigated by comparing the proportion of goblet cells with the corresponding Reid index. No significant correlation was found between nasal and bronchial mucous gland size, and no association was demonstrated between the proportion of goblet cells in the sinus mucosa and the presence of chronic bronchitis as assessed by the Reid index. These findings suggest that a direct association between chronic bronchitis and chronic sinusitis probably does not exist, and that the inclusion of chronic bronchitis in the `sino-bronchial syndrome' is not valid. We feel that this term should be restricted to the association of chronic sinusitis with bronchiectasis or adult pulmonary mucoviscidosis. If either infection or air pollution were the predominant cause of mucous gland hypertrophy, changes similar to those found in the bronchi would be expected in the nose and sinuses. Since our results show they are not found there, then some other factor, such as cigarette smoking, must be responsible.
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