Skip to main content

Prognostic value of Helicobacter pylori sinonasal colonization for efficacy of endoscopic sinus surgery

Abstract

Compared with rhinologic patients without chronic rhinosinusitis (CRS), a higher prevalence of sinonasal Helicobacter pylori (HP) in patients with CRS was found. This study investigated if HP sinonasal colonization has a prognostic value for efficacy of functional endoscopic sinus surgery (FESS). Nasal polyps of 40 patients with CRS, undergoing FESS, were analyzed for presence of HP using immunohistochemistry (IHC). Patients were categorized as to whether the IHC was positive (HP+ group) or negative (HP− group). HP+ group and HP− group were compared according to the nasal polyp eosinophil density, and to the improvement (difference between pre- and post-operative scores) of the subjective symptom scores, and the nasal endoscopic scores. Nasal polyps in 28 (70%) patients were positive for HP. There were no significant differences between HP+ group and HP− group comparing the eosinophils, and the improvement of the single symptom and the total symptom scores. HP+ group had significantly greater improvement of the nasal endoscopic scores (F[1.38] = 6.212; P = 0.017). There is no influence of sinonasal HP on tissue eosinophilia and on CRS symptoms. There is a prognostic value for endonasal findings: CRS patients with HP have statistically significant greater improvement of the postoperative endoscopic scores.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. 1.

    DelGaudio JM (2005) Direct nasopharyngeal reflux of gastric acid is a contributing factor in refractory chronic rhinosinusitis. Laryngoscope 115:946–957

    PubMed  Article  Google Scholar 

  2. 2.

    Graham DY (1997) Helicobacter pylori infection in the pathogenesis of duodenal ulcer and gastric cancer: a model. Gastroenterology 113:1983–1991

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Koc C, Arikan OK, Atasoy P, Aksoy A (2004) Prevalence of Helicobacter pylori in patients with nasal polyps: a preliminary report. Laryngoscope 114:1941–1944

    PubMed  Article  Google Scholar 

  4. 4.

    Kim HY, Dhong HJ, Chung SK, Chung KW, Chung YJ, Jang KT (2007) Intranasal Helicobacter pylori colonization does not correlate with the severity of chronic rhinosinusitis. Otolaryngol Head Neck Surg 136:390–395

    PubMed  Article  Google Scholar 

  5. 5.

    Khalil H, Nunez DA (2009) Functional endoscopic sinus surgery for chronic rhinosinusitis. Cochrane Database Syst Rev. http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004458/pdf_fs.html. Accessed 1 Feb 2011

  6. 6.

    Smith TL, Litvack JR, Hwang PH et al (2010) Determinants of outcomes of sinus surgery: a multi-institutional prospective cohort study. Otolaryngol Head Neck Surg 142:55–63

    PubMed  Article  Google Scholar 

  7. 7.

    Fokkens W, Lund V, Mullol J et al (2007) European position paper on rhinosinusitis and nasal polyps 2007. Rhinology 45:S1–S136

    Google Scholar 

  8. 8.

    Lund VJ, Mackay IS (1993) Staging in rhinosinusitis. Rhinology 31:183–184

    PubMed  CAS  Google Scholar 

  9. 9.

    Baudoin T, Kalogjera L, Geber G, Grgić M, Čupić H, Kujundžić Tiljak M (2008) Correlation of histopathology and symptoms in allergic and non-allergic patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol 265:657–661

    PubMed  Article  Google Scholar 

  10. 10.

    Baudoin T, Čupić H, Geber G, Vagić D, Grgić M, Kalogjera L (2006) Histopathologic parameters as predictors of response to endoscopic sinus surgery in nonallergic patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 134:761–766

    PubMed  Article  Google Scholar 

  11. 11.

    Malm L (1997) Assessment and staging of nasal polyposis. Acta Otolaryngol 117:465–467

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Monsó E, Rosell A, Bonet G et al (1998) Impacto de la colonización bronquial en la calidad de vida del paciente con bronquitis crónica estable. Med Clin (Barc) 111:561–564

    Google Scholar 

  13. 13.

    Benninger MS, Ferguson BJ, Hadley JA et al (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 129:S1–S32

    PubMed  Article  Google Scholar 

  14. 14.

    Babus V, Presecki V, Katicić M et al (1997) Distribution of Helicobacter pylori infection in the adult population of Croatia [in Croatian]. Lijec Vjesn 119:139–142

    PubMed  CAS  Google Scholar 

  15. 15.

    Andersen LP, Holck S, Povlsen CO (1988) Campylobacter pylori detected by indirect immunohistochemical technique. APMIS 96:559–564

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Quiding-Järbrink M, Raghavan S, Sundquist M (2010) Enhanced M1 macrophage polarization in human Helicobacter pylori-associated atrophic gastritis and in vaccinated mice. PloS One. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990716/pdf/pone.0015018.pdf. Accessed 16 Jan 2011

  17. 17.

    Kim JM, Kim JS, Lee JY et al (2010) Dual effects of Helicobacter pylori vacuolating cytotoxin on human eosinophil apoptosis in early and late periods of stimulation. Eur J Immunol 40:1651–1662

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Nagy TA, Allen SS, Wroblewski LE et al (2011) Helicobacter pylori induction of eosinophil migration is mediated by the cag pathogenicity island via microbial-epithelial interactions. Am J Pathol 178:1448–1452

    PubMed  Article  Google Scholar 

  19. 19.

    Corley DA, Kubo A, Levin TR et al (2008) Helicobacter pylori and gastroesophageal reflux disease: a case–control study. Helicobacter 13:352–360

    PubMed  Article  Google Scholar 

  20. 20.

    Oridate N, Takeda H, Yamamoto J et al (2006) Helicobacter pylori seropositivity predicts outcomes of acid suppression therapy for laryngopharyngeal reflux symptoms. Laryngoscope 116:547–553

    PubMed  Article  Google Scholar 

  21. 21.

    Blaser MJ (2000) The amphibiotic relationship of Helicobacter pylori and humans. In: Hunt RH, Tytgat GNJ (eds) Helicobacter pylori basic mechanisms to clinical cure 2000. Kluwer, Dordrecht (Netherlands), pp 25–30

    Google Scholar 

  22. 22.

    Hamlet A, Croitoru K (2000) Overview of immune and inflammatory changes due to Helicobacter infection. In: Hunt RH, Tytgat GNJ (eds) Helicobacter pylori basic mechanisms to clinical cure 2000. Kluwer, Dordrecht (Netherlands), pp 141–150

    Google Scholar 

  23. 23.

    Ozyurt M, Gungor A, Ergunay K, Cekin E, Erkul E, Haznedaroglu T (2009) Real-time PCR detection of Helicobacter pylori and virulence-associated cagA in nasal polyps and laryngeal disorders. Otolaryngol Head Neck Surg 141:131–135

    PubMed  Article  Google Scholar 

  24. 24.

    Smith TL, Rhee JS, Loehrl TA, Burzynski ML, Laud PW, Nattinger AB (2003) Objective testing and quality-of-life evaluation in surgical candidates with chronic rhinosinusitis. Am J Rhinol 17:351–356

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors are indebted to Dr. Božo Petrov, M.Sc., and Prof. Darko Hren, Ph.D., for the statistical analysis. This work has been done as a part of the scientific project "Research of chronic rhinosinusitis and its comorbidity" supported by the Ministry of Science, Education and Sports of the Republic of Croatia (No. 108-0650235-0177).

Conflict of interest

None declared.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Boris Jelavic.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jelavic, B., Grgić, M., Čupić, H. et al. Prognostic value of Helicobacter pylori sinonasal colonization for efficacy of endoscopic sinus surgery. Eur Arch Otorhinolaryngol 269, 2197–2202 (2012). https://doi.org/10.1007/s00405-012-1923-9

Download citation

Keywords

  • Chronic rhinosinusitis
  • Nasal polyps
  • Helicobacter pylori
  • Functional endoscopic sinus surgery
  • Prognosis