A prospective cohort-study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus

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 analyzed.

Design

This was a prospective cohort study. Follow-up was done using a postal questionnaire.

Setting

One otolaryngologists' office comprising three medical doctors.

Participants

122 consecutive globus patients presenting to one otolaryngology office in a one-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 y] and a female predominance was found (ratio 1.49). 84% 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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