Rasmussen ER, Schnack DT, Ravn AT. A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus.
Clin Otolaryngol 2018;
43:854-860. [PMID:
29327493 DOI:
10.1111/coa.13065]
[Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2018] [Indexed: 01/29/2023]
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.
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