[Globus sensation : A clinical review].

Globus sensation is a medially felt lump in the throat. It can be associated with a number of different diseases, but this symptom may also occur monosymptomatically as a somatoform disorder or as a secondary somatoform illness behavior. Globus sensation may be persistent or intermittent. Diagnosis requires close interdisciplinary cooperation, since the globus may be a symptom of anxiety, depression or personality disorders. Firstly, patients should undergo a thorough otolaryngological examination (including careful medical history taking), possibly in cooperation with other medical specialists. Subsequent psychosomatic and clinical tests - if necessary - may be time-consuming due to complex interrelations between somatic vulnerability and psychosocial coping strategies. Sometimes a comorbid disorder is diagnosed and the primary disease treated; however, the identification of multiple etiologically effective mechanisms is impossible. If the patient is unable to accept his benign monosymptomatic globus as a somatoform disorder (ICD-10; F45.8), a combination of pharmacologic intervention and cognitive-behavioral intervention as an integrated treatment approach is recommended. However, the symptom has a strong tendency to recur. Since controlled therapy studies are scant to date, evidence-based treatment concepts are currently not available.