Intranasal Helicobacter Pylori Colonization in Chronic Rhinosinusitis Patients

Chung, Kyu Whan; Dhong, Hun Jong; Chung, Seung Kyu; Kim, Hyo Yeol; Chung, Young Jun; So, Yoon Kyoung

Abstract

BACKGROUND AND OBJECTIVES: Helicobacter pylori (HP) has been reported to be detected in lower esophagus, palatine tonsil, and adenoid. The object of this study was to investigate the prevalence of HP in the nasal cavity of chronic rhinosinusitis (CRS) patients and compare the results with those of healthy controls.
SUBJECTS AND METHOD
43 patients aged 18 to 68 years with CRS who underwent endoscopic sinus surgery and 16 healthy controls aged 24 to 72 years without sinus diseases were enrolled in this study. Tissue samples were collected from nasal polyp or the mucosa of sphenoethmoidal recess. HP infection of nasal cavity was investigated using rapid urease (CLO) test and immunohistochemical (IHC) analysis. GER symptoms and esophagogastroscopic findings were gathered by questionnaire or medical records.
RESULTS
HP was detected in nasal cavity by CLO test in 17 of 43 patients (40%) with CRS compared with none of 16 healthy controls (0%) (p=0.003), and 19 of 43 patients (44%) by IHC analysis compared with 2 of 16 healthy controls (13%) (p=0.032). Eleven of 43 patients (26%) were positive in both CLO test and IHC analysis but none of controls (0%) was positive in both two tests (p=0.026). Four of 8 patients (50%) who complained GER specific symptoms were HP positive in both two tests (p=0.033).
CONCLUSION
HP was detected in nasal cavity and it was more prevalent in patients with CRS than healthy controls without sinus diseases. GER may have a positive correlation with the colonization of HP. However, whether HP is a causative agent for CRS or a result of CRS is not known.