Characteristics of thyroid nodules causing globus symptoms

Abstract

A globus sensation is one of the most common complaints in otolaryngologic clinics, and laryngopharyngeal reflux is the most common cause. However, thyroid nodules also can cause globus symptoms. The purpose of this study was to identify the characteristics of thyroid nodules that cause globus. We selected patients prospectively with a single thyroid nodule on ultrasonograms. Patients with other causes of globus symptoms were excluded using questionnaires, fiber optic laryngoscopic examinations, and a psychiatric screening tool. In total, 175 patients were enrolled. Patients were divided into two groups according to globus symptoms. Ultrasonographic characteristics and clinicopathological parameters were compared between the groups. Among various clinicopathologic and ultrasonographic parameters, size and horizontal location of the thyroid nodule showed significant differences between the groups. Nodules larger than 3 cm and those located anterior to the trachea had a tendency to cause globus symptoms. Regarding horizontal location, nodules that all parts were located anterior to the trachea showed a higher tendency to cause globus symptoms than nodules that only some parts were located anterior to the trachea. In conclusion, thyroid nodules with specific size and location can cause globus symptoms, and this finding can be indicated in patient counseling. Also, conservative treatments or thyroidectomy may be helpful in relieving patients' globus symptoms.

Work-up of globus: assessing the benefits of neck ultrasound and videofluorography

“…Four years later, a tumor was palpable and further examination revealed thyroid cancer. But as the authors concluded, the association between small thyroid nodules and globus sensation is unlikely [18]. Lingual tonsil hypertrophy was the suspected cause for globus in three of our patients (4 %).…”

“…One-third of patients with a thyroid mass such as goiter may have a globus-like symptom, but after thyroid surgery are expected to experience improvement, [17] difficult to attribute to surgery or to spontaneous recovery. Moreover, thyroid nodules larger than 3 cm located anterior to the trachea have had a tendency to cause globus symptoms [18]. One of our globus patients had a couple of goiter nodules sized less than 1 cm diagnosed in neck ultrasound in 2009.…”

Organik patolojisi olmayan, globus farengeus ile başvuran hastaların değerlendirilmesi

“…Globus farengeusa neden olan birçok etyolojik etken bulunmaktadır. Psikolojik faktörlerin [4] yanı sıra farengeal dismotilite, [5] üst özofageal sfinkter hipertonisisitesi, [6] gastroözofageal reflü, [7,8] tiroid hastalıkları, [9] lokal anatomik bozukluklar [10,11] da etyolojide yer almaktadır. Çalışmaların çoğunda hastaların %60'ını kadınlar oluşturmaktadır.…”

Globus Pharyngeus: Etiology, Diagnostics and Treatment

“…41 Özellikle trakea önüne yerleşimli ve boyutu 3 cm'den büyük nodüllerin globus hissine sebep olduğu düşünül-mektedir. 42 Tüm bunlara rağ men, nodül ve benzeri tiroidal bulgulara sağ lıklı popülasyonda da sıklıkla rastlandığı için konu ile ilgili daha fazla araştırmaya ihtiyaç duyulmaktadır.…”