Helicobacter pylori and its role in vocal folds' minimal lesions

Chronic laryngitis and/or vocal fold minimal lesions (VFMLs) are common associations with gastro esophageal reflux disease. Helicobacter pylori (HP) is a Gram-negative spiral organism accused of being a common cause of gastritis, gastroesophageal reflux disease and peptic ulcer. HP has been recently isolated from tonsils, adenoids, sinus and middle ear mucosa in patients with chronic sinusitis or chronic middle ear effusion.

The objective of this study is to assess the presence of HP in VFMLs.

The study included 14 patients with VFMLs [six cases with vocal fold polyps and four cases with vocal fold nodules, and four cases with posterior granulomas; one of them associated with right vocal fold (VF) nodule]; all underwent carbon-13 urea breath test, esophago-gastro-duodenoscopy with gastric biopsy and direct laryngoscopy with microlaryngosurgery to extract the VF lesions. Biopsies were subjected for two tests: detection of the 23S ribosomal RNA gene of HP by real-time polymerase chain reaction (RT-PCR) and immunohistochemical reactions (IHC).

HP was detected by RT-PCR in 10 of 14 patients with VFML; HP was also detected by IHC in the same number of VFML and gastric mucosa specimens.

HP is a common finding in cases of VFML; its eradication should be considered when dealing with a patient with VFML.