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

Abstract

Objective: A globus sensation is one of the most common complaints in otolaryngological practice. Patients with no associated abnormalities detected during the usual examinations performed in ENT clinics, are being diagnosed with globus sensation. Cervical ultrasonography is usually not performed in ENT clinics; however, it is useful in screening diseases of the subcutaneous tissue/organs, whose detection is not possible with the routine ENT examinations. The purpose of our study was to elucidate whether cervical ultrasound examination identifies abnormalities in patients with globus sensation. Design: A single-centre retrospective cohort study. Cervical ultrasonographic examinations were performed on patients with globus sensation from January 2013 to September 2017. Setting: Department of Otolaryngology of Tottori university hospital, a tertiary care centre Participants: The subjects were 74 patients (42 women and 32 men) experiencing globus sensation with no abnormality detected on general otolaryngological examination (including laryngoscopy). The mean age was 58.4 years. Main outcomes: The primary outcome measure was the percentage of patients with globus sensation who have structural abnormalities detected by cervical ultrasonography. Results: Ultrasonography detected structural abnormalities in 60.8% of the patients with globus sensation: thyroid disorders in 41 patients, including: 35 patients with thyroid nodules, 4 patients with Hashimoto's disease, 1 patient with Grave's disease, and 1 patient with subacute thyroiditis; Sjögren syndrome in 2 patients; and cervical lipoma in 1 patient. Furthermore, 2 patients with thyroid disorders had concomitant oesophageal cancer. Conclusions: Cervical ultrasonography identified thyroid disorders in patients with globus sensation, despite the normal ENT status. Therefore, it would be appropriate to adopt cervical ultrasonography as a routine examination at ENT clinics for patients with globus sensation.