A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus

Abstract

Objectives: To investigate the epidemiology of globus pharyngeus in adult patients presenting to the otolaryngologist's office. Also, the predictors of persisting symptoms, prevalence of anxiety and the effect of clinical assessment were analysed.Design: This was a prospective cohort study. Follow-up was carried out using a postal questionnaire.Setting: One otolaryngologists' office comprising three medical doctors.Participants: A total of 122 consecutive globus patients presenting to one otolaryngology office in a 1-year period.Main outcome measures: Globus incidence, gender and age distribution, predictors of persisting symptoms and the patient's health-related concerns.Results: 3.8% of first-time visits were regarding globus. The mean age was 48 years [range 20-88 years], and a female predominance was found (ratio 1.49). Eighty-four per cent experienced anxiety, mainly due to fear of cancer. The most common pathological findings were reflux (15.6%) and post-infectious inflammation (10.6%). 21.4% of questionnaire responders reported full remission of their symptoms. Three predictors regarding symptom persistence were identified: male gender (OR 1.52), smoking (OR 3.4) and difficulties in breathing (OR 8.7). Patients with concomitant foreign body sensation were less likely to have persisting symptoms (OR 0.42). No cases of malignant disease were encountered. 94.7% was reassured by the office visit.Conclusion: The incidence of globus is 3.8% in the otolaryngologist's office. Female gender and concomitant foreign body sensation were predictive for presenting to the clinic even if symptom remission had occurred. Male gender, smoking and self-perceived breathing difficulties were predictive for persisting symptoms. Globus is an anxiety-causing symptom, but reassurance is provided by clinical examination by the otolaryngologist.

Globus Pharyngeus: Etiology, Diagnostics and Treatment

“…Son zamanlarda 122 globus tanılı birey ile yapılan bir çalışmada, hastaların %44'ü probleme bağlı anksiyete yaşadığını dile getirirken, bu hasta grubunda en yaygın görülen patolojik bulgular ise %15,6 reflü, %10,6 post-enfeksiyöz inflamasyon ve %7,4 nazal kavite patolojileri olarak saptanmıştır. 2 Bu sebepleri destekleyen pek çok çalışma olduğu gibi, aksini dile getiren çalışmalar da mevcuttur. Bu nedenle GF etiyolojisi ile ilgili literatürde hâlâ tartışmalı sonuçlar yer almaktadır.…”

ESNM/ANMS Review. Diagnosis and management of globus sensation: A clinical challenge

“…A population survey of 6300 individuals in the United States, UK, and Canada reports a prevalence of 8.1%, with similar prevalence in each of the three regions 8 . Globus may account for as many as 4% of new referrals to ENT clinics 9,10 . Anxiety, depression, and sleep disorders were reported more often in patients with globus than those without the symptom 7 .…”

Use of cervical ultrasonography in globus sensation investigation: a retrospective cohort study

“…The definition of globus sensation has been changing depending on medical technology used in routine care. Many studies investigated the correlation between gastropharyngeal reflux disease and globus sensation, using video fluorography and pH monitoring devices [5][6][7][8]. Nowadays, we can use a flexible fiberscope for general examination.…”