Abstract
The bacteria Helicobacter pylori (H. pylori) have been identified in the extragastric tissues in the head and neck. The origin and pathogenicity of these bacteria in the head and neck are not known. Gastric reflux and nasal or oral routes are the possible modes of spread. In many sinonasal, pharyngeal, laryngeal, and middle ear disorders, laryngopharyngeal reflux has been identified as a contributing or causative factor. One possible mode by which laryngopharyngeal reflux may contribute is by seeding of the extragastric mucosa with H. pylori. The clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear. There is no evidence of a pathologic or active role of H. pylori in otorhinolaryngological disorders. The suggestion that the sinonasal cavities and pharynx may serve as a reservoir for H. pylori and that reinfection of the stomach occurs after eradication therapy awaits further studies for confirmation. No connection was observed between H. pylori found in the stomach and H. pylori found in the head and neck. Also, these bacteria, found in the head and neck tissues, may be accidental or innocent bystanders that do not affect the pathways of otolaryngological and gastroduodenal diseases. This review examines the evidence for a possible relationship of H. pylori with otorhinolaryngological diseases.
Highlights
The role of the bacteria Helicobacter pylori (H. pylori) in gastroduodenal disease is well established, the clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear
The suggestion that the sinonasal cavities and pharynx may serve as a reservoir for H. pylori and that reinfection of the stomach occurs after eradication therapy awaits further studies for confirmation
This review examines the evidence for a possible relationship of H. pylori with otorhinolaryngological diseases
Summary
The role of the bacteria Helicobacter pylori (H. pylori) in gastroduodenal disease is well established, the clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear. It has been suggested that these coccoid forms constitute a dormant resistant form of the bacterium that may revert into an infectious spiral form in appropriate conditions and result in recrudescence of infection [10] These findings imply that the sinonasal cavities may be a reservoir for H. pylori and possible gastric recolonization rather than that H. pylori having an active role in CRS. The sinonasal tissue pepsin/pepsinogen never rose above blood levels This finding implies that H. pylori colonizes the sinus mucosa via a nasal or. A possible predictive value of H. pylori sinonasal colonization for efficacy of endoscopic sinus surgery in patients suffering from CRS with nasal polyps has been studied [12]. They found a decreased prevalence of H. pylori gastric colonization in subjects with
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