[ relationship between the colonization of helicobacter pylori in the mucosa of the paranasal sinuses and chronic sinusitis]

ABSTRACT

Chronic rhinosinusitis is one of the most common chronic diseases which can adversely affect patients' quality of life with a considerable economical burden. Bacteriology of chronic rhino sinusitis is not well defined. Recently, Helicobacter pylori gained a considerable concern in respect to its probable association with upper respiratory tract diseases. This study aimed to evaluate the relationship between H. pylori colonization in sinonasal mucosa and chronic rhinosinusitis. This case-control study was conducted in Ayatollah Taleghani General Hospital - Tehran in 2007-2008. All patients with chronic rhinosinusitis who failed to respond to the medical therapy [32 patients], enrolled as case group and samples were taken from involved sinonasal mucosa during endoscopic surgery. Patients with nasal septum deviation [65 cases] recruited as control group and samples were evaluated for Helicobacter colonization by using polymerase chain reaction [PCR] technique and results in two groups were compared. 97 patients [61% male and 39% female] were studied ranging in age from 12 to 53 years, with an average of 29.6 years. Out of 32 patients in the case group, 56% were male and 44% female, aging from 12 to 53 years [averagely 32.16 years]. 65 cases of the control group [63% male and 37% female] were 16-50 years old with an average age of 28.34 years. After the evaluation of samples from 97 patients in both study groups, 16 patients out of 32 in chronic rhino sinusitis group [50%] and 7 out of 65 patients in control group [10.7%] had positive results for helicobacter colonization in their sinonasal and bulla ethmoidalis mucosa which was statistically significant [p<0.001, and Odds Ratio= 8.28, 95% CI= 2.9-23.59]. There was no statistically significant relation between H. pylori colonization and site of involved sinus or typical symptoms of gastro-esophageal reflux. According to the results of current study, there was a significantly higher rate of Helicobacter pylon colonization in chronic rhinosinusitis patients compared to the control group. This finding suggests that Helicobacter pylori may play an etiologic role in pathogenesis of chronic rhinosinusitis