Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-27T06:42:07.023Z Has data issue: false hasContentIssue false

The globus syndrome: value of flexible endoscopy of the upper gastrointestinal tract

Published online by Cambridge University Press:  29 June 2007

Reinhard Lorenz*
Affiliation:
2nd Department of Internal Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Germany
Gabriele Jorysz
Affiliation:
2nd Department of Internal Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Germany
Meinihard Clasen
Affiliation:
2nd Department of Internal Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Germany
*
Reinhard Lorenz, M.D., 2nd Department of Internal Medicine, Technical University of Munich, Klinikum Rechts Der Tsar, Ismaninger Strasse 22, D-8000 MOnchen 80, Germany

Abstract

Flexible endoscopy of the upper gastrointestinal tract usually does not form part of the primary diagnostic evaluation of the globus syndrome. In a prospective trial, a flexible endoscopy was performed in 51 globus patients with normal results of the laryngologic and radiographic examination. Pathologic findings requiring therapy were diagnosed in 70.6 per cent of cases. The most frequent findings were reflux oesophagitis (n = 24; 47 per cent) and hiatial hernia (n = 25; 49 per cent). In 16 cases (31,4 per cent) these were accompanied by other pathologic lesions. A total of 32 patients (62.7 per cent) suffered from oesophageal diseases as sole aetiologic factors of the globus syndrome, which led us to postulate a causative relationship in these cases. Flexible endoscopy therefore can contribute significantly to the differential diagnosis of the globus syndrome. It must be kept in mind, however, that there is a ‘blind zone’ for endoscopic assessment in a region of the hypopharynx, thus some indications may require rigid endoscopy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Batch, A. J. G. (1988) Globus pharyngitis. Part I. Journal of Laryngology and Otology, 102: 152158.Google Scholar
Bingham, B. J., Drake-Lee, A., Cherretton, E., White, A. (1986) Pitfalls in the assessment of dysphagia by fibreoptic oesophagogastroscopy. Annals of the Royal College of Surgeons of Englan 68: 2223.Google Scholar
Delahunty, J. E., Ardran, G. M. (1970) Globus hystericus: a manifestation of reflux oesophagitis? Journal of Laryngology and Owlaryngology, 84: 10491054.Google Scholar
Editorial (1989) A lump in the throat. Lancet i: 534.Google Scholar
Halpert, R. D., Feczko, P. J., Spickler, E. M., Ackerman, L. V. (1985) Radiological assessment of dysphagia with endoscopic correlation. Radiology 157: 599602.Google Scholar
Hunt, P. S., Conell, A. Z. M., Smiley, T. B. (1970) The cricopharyngeal sphincter in gastric reflux. Gut 11: 303306.CrossRefGoogle ScholarPubMed
Kahn, K. L., Kosecoff, J., Chassin, M. R., Solomon, D. H., Brook, R. H. (1988) The use and misuse of upper gastrointestinal endoscopy. Annals of Internal Medicine 109: 664670.Google Scholar
Moloy, P. J., Charter, R. (1982) The globus syndrome. Archives of Otolaryngology 108: 740744.Google Scholar
Steinmann, E. P. (1961) Globus pharyngis und Hiatus-hemie. Schweizerische Medizinishche Wochenschrift 91: 304306.Google Scholar
Wilson, J. A., Maran, A. G. D., Pryde, A., Pins, J., Allan, P. L., Heading, R. C. (1987) Globus sensation is not due to gastroesophageal reflux. Clinical Otolaryngology 12: 271275.Google Scholar