The following ideas and questions, suggested by the present state of our knowledge regarding the function and malfunction of respiratory mucous membrane, deserve a high priority in the field of research: 1. Although it seems clear, from the many studies in the experimental animal and in vitro and the relatively few in man, that, although the mucociliary apparatus is remarkably resistant to injury, injury can and does occur. To what degree is there an association between minor mucosal malfunction, insufficient in itself to produce signs or symptoms, and susceptibility to respiratory disease? Is it possible that many of those patients whom we see with relatively severe, intractable or recurrent respiratory infections suffer from malfunction similar to that which we know to be so dangerous in mucoviscidosis? Until more investigation is done in both normal and diseased man we cannot say. 2. If such minor malfunction is an important factor in disease what can we do to protect mucosa or restore its normal function when impaired? 3. Is there a relation between mucosal function and airway dynamics in the lung? If so, how is it related to such factors as mouth breathing, air pollution, infection, artificial or natural variations in the environmental atmosphere or other possible noxious influences? 4. If the nose is an important defense organ what structural abnormalities are most injurious and what is the optimum manner for their correction? Tools are now available for many of these investigations of respiratory mucous membrane physiology and pathology, and other superior methods will undoubtedly be developed. What is needed is for bright young minds to become interested in these important problems. Is it possible that the ever-increasing emphasis on plastic surgery, oncology and the surgery of deafness in the field of otolaryngology is leading to a neglect of the major public health hazards associated with respiratory disease? Such a possibility is at least worthy of consideration by specialists and teachers in the field to which most patients with respiratory complaints turn when in trouble. © 1969, SAGE Publications. All rights reserved.
