E R Rasmussen1,2, D T Schnack2,3, A T Ravn2. 1. Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 2. The Ear- Nose and Throat Clinic, Frederiksberg, Denmark. 3. The Ear- Nose and Throat Clinic, Nykoebing Falster, Denmark.
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.
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.