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Management of globus pharyngeus: review of 699 cases

Published online by Cambridge University Press:  16 March 2006

R.P.S. Harar
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Southend Hospital, Southend, UK.
S. Kumar
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Southend Hospital, Southend, UK.
M.A. Saeed
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Southend Hospital, Southend, UK.
D.J. Gatland
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Southend Hospital, Southend, UK.

Abstract

The principal reason for performing investigations in patients with globus pharyngeus is to detect a pharyngeal or upper oesophageal malignancy presenting this way. There is uncertainty regarding both the necessity for investigation in globus patients and the first line investigation of choice in the screening of such patients. The authors therefore undertook a retrospective study of 699 patients who presented with globus sensation. Of these, 451 patients (64.5 per cent) had a typical history and in these patients, outpatient examination, including fibre-optic nasendoscopy was able to detect all pathologies, except one insignificant pharyngeal pouch, which required no intervention and one patient with a distal peptic stricture. In patients with atypical symptoms the combination of fibre-optic nasendoscopy and barium swallow identified all pathologies (five aerodigestive tract malignancies) except one distal peptic stricture. The authors concluded that if out-patient examination is adequate, no further investigation of typical globus symptoms is required. Such a policy would produce significant savings for both out-patient and radiology services.

Type
Research Article
Copyright
© 2004 Royal Society of Medicine Press

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