Detection of Helicobacter Pylori in the lacrimal sac mucosa of the patients with primary acquired nasolacrimal duct obstruction

Abstract
Helicobacter pylori have been detected in sinonasal mucosa in both normal and pathologic condition. The nasolacrimal duct is within the medial wall of maxillary sinus and open into the nasal cavity, so ascending colonization of nasolacrimal duct and lacrimal sac is possible. The aim of this study is to investigate the presence of H. pylori by polymerase chain (PCR) reaction in the nasal and lacrimal sac mucosa of the patients with primary acquired nasolacrimal duct obstruction. Eighty patients with primary acquired nasolacrimal duct obstruction who were scheduled for dacryocystorhinostomy enrolled in the study. The patients were asked if they suffered from the classic symptoms of gastroesophageal reflux disease (heart burn, regurgitation, and acid taste). Tissue samples from the lacrimal sac mucosa and nasal mucosa were obtained during dacryocystorhinostomy surgery. The tissues were analyzed for detection of H. pylori DNA by PCR. The mean age of patients was 41.96±14.7 years (age range, 17-84 Years). PCR for H. pylori DNA was positive in the nasal mucosa in 3 patients, in the lacrimal sac mucosa in 2 patients and in both nasal mucosa and lacrimal sac mucosa in 1 patient. Classic symptoms of gastroesophageal reflux disease were found in 16 patients (20%). It is possible to detect H. pylori in the lacrimal sac mucosa of some patients with primary acquired nasolacrimal duct obstruction. More comprehensive studies are needed to determine whether H. pylori plays an etiopathologic role in the development of primary acquired nasolacrimal duct obstruction