Hyperviscoelasticity of epipharyngeal mucus may induce globus pharyngis.

Detailed observation reveals a lump of translucent sticky mucus standing in the epipharynx of most globus patients, suggesting that the mucus adherent to the epipharynx causes a globus sensation. The epipharyngeal mucus of 70 consecutive globus patients was sampled via the nasal cavity. Fucose and sialic acid, the determinants of the viscoelasticity of mucus, were measured. Twenty-three patients were also asked to complete the Throat Questionnaire so we could evaluate the correlation between the degree of globus sensation and the viscoelasticity of the mucus. The mucus of 10 healthy subjects was sampled, analyzed, and compared with the data of the patients. The fucose and sialic acid concentrations found in the patients with globus pharyngis were significantly higher than those in the control subjects (Mann-Whitney U test, p < .01). The fucose concentrations correlated significantly with the globus pharyngis scores (Spearman correlation, p < .05). We conclude that there is a close association between stagnant mucus in the epipharynx and globus sensation.