Globus pharyngis, globus hystericus or globus sensation is the persistent but painless sensation of having a pill, food bolus, or some other sort of obstruction in the throat when there is none. Swallowing is typically performed normally, so it is not a true case of dysphagia, but it can become quite irritating. It is common, with 22–45% of people experiencing it at least once in their lifetime.[1][2]
The results of recent studies have strongly suggested that GERD is a major cause of globus, though this remains under considerable debate.[6]
A less common cause, distinguished by a "lump in the throat" accompanied with clicking sensation and considerable pain when swallowing, may be due to thyroid-cartilage rubbing against anomalous asymmetrical laryngeal anatomy e.g. the superior cornu abrading against the thyroid lamina,[7][8] surgically trimming the offending thyroid-cartilage provides immediate relief in all cases.[3] However this cause is frequently misdiagnosed, despite requiring a simple clinical examination involving careful palpation of the neck side to side which elicits the same click sensation (laryngeal crepitus) and pain as when swallowing, most cases are due to prior trauma to the neck.[3] High resolution computed tomographic (CT) or MRI scan of the larynx is usually required to fully understand the anomalous laryngeal anatomy. Anterior displacement of the thyroid ala on the affected side while swallowing can help resolve symptoms.[citation needed] Other anomalous laryngeal anatomy with the potential to cause the globus sensation include thyroid nodules or parathyroid adenomas.[9]
Diagnosisedit
As globus sensation is a symptom, a diagnosis of globus pharyngis is typically a diagnosis of exclusion. If globus sensation is presenting with other symptoms such as pain, swallowing disorders such as aspiration or regurgitation (dysphagia), weight loss, or voice change,[10] an organic cause needs to be investigated, typically with endoscopy. Barium swallows are not recommended as a diagnostic tool as although they are less invasive than endoscopy and may be reassuring to the patient, they commonly miss sinister causes. It is very rare that globus sensation presenting with no other symptoms has a sinister cause and therefore endoscopy is not recommended in this case.[10][11]
Differential diagnosisedit
Differential diagnosis must be made from Eagle syndrome which uses the patient's description of "something caught in my throat" as a diagnostic tool. Eagle syndrome is an elongation of the styloid process causing irritation to nerves and muscles in the region resulting in a number of unusual symptoms.[citation needed]
Managementedit
Reassurance of the patient is recommendable when no cause can be found. If a cause is identified, treat the cause symptomatically or, if possible, systemically.[citation needed]
Referencesedit
^Robson KM, Lembo AJ. "Globus Sensation". UpToDate. Retrieved 2019-08-31.
^Jones D, Prowse S (October 2015). "Globus pharyngeus: an update for general practice". The British Journal of General Practice. 65 (639): 554–55. doi:10.3399/bjgp15X687193. PMC4582871. PMID 26412835.
^ abcSmith ME, Berke GS, Gray SD, Dove H, Harnsberger R (September 2001). "Clicking in the throat: cinematic fiction or surgical fact?". Archives of Otolaryngology–Head & Neck Surgery. 127 (9): 1129–31. doi:10.1001/archotol.127.9.1129. PMID 11556866.
^Cybulska EM (1997). "Globus hystericus – a somatic symptom of depression? The role of electroconvulsive therapy and antidepressants". Psychosomatic Medicine. 59 (1): 67–69. doi:10.1097/00006842-199701000-00009. PMID 9021868. S2CID 24181148.
^Cybulska EM (August 1998). "Globus hystericus or depressivus?". Hospital Medicine. 59 (8): 640–41. PMID 9829059.
^Lee BE, Kim GH (May 2012). "Globus pharyngeus: a review of its etiology, diagnosis and treatment". World Journal of Gastroenterology. 18 (20): 2462–71. doi:10.3748/wjg.v18.i20.2462. PMC3360444. PMID 22654443.
^Nadig SK, Uppal S, Back GW, Coatesworth AP, Grace AR (July 2006). "Foreign body sensation in the throat due to displacement of the superior cornu of the thyroid cartilage: two cases and a literature review". The Journal of Laryngology and Otology. 120 (7): 608–09. doi:10.1017/S0022215106001125. PMID 16681864. S2CID 20575227.
^Srikantha, Luxman; Amjad, Esmael H.; Beydoun, Rafic (2020-12-29). "Sudden Odynophagia and Globus—A Unique Presentation of a Nonsecreting Parathyroid Adenoma: A Case Report and Literature Review". Case Reports in Otolaryngology. 2020: 6805805. doi:10.1155/2020/6805805. ISSN 2090-6765. PMC7785386. PMID 33457030.
^ abKortequee S, Karkos PD, Atkinson H, Sethi N, Sylvester DC, Harar RS, et al. (2013). "Management of globus pharyngeus". International Journal of Otolaryngology. 2013: 946780. doi:10.1155/2013/946780. PMC3725834. PMID 23935629.
^Manabe N, Tsutsui H, Kusunoki H, Hata J, Haruma K (2014). "Pathophysiology and treatment of patients with globus sensation – from the viewpoint of esophageal motility dysfunction". Journal of Smooth Muscle Research = Nihon Heikatsukin Gakkai Kikanshi. 50: 66–77. doi:10.1540/jsmr.50.66. PMC5137314. PMID 26081369.
External linksedit
"Globus Sensation. Myasthenia gravis and globus information". patient.info. Retrieved 29 April 2018.
December 15, 2023
globus, pharyngis, lump, throat, redirects, here, emotional, response, crying, biological, response, globus, hystericus, globus, sensation, persistent, painless, sensation, having, pill, food, bolus, some, other, sort, obstruction, throat, when, there, none, s. Lump in the throat redirects here For the emotional response see Crying Biological response Globus pharyngis globus hystericus or globus sensation is the persistent but painless sensation of having a pill food bolus or some other sort of obstruction in the throat when there is none Swallowing is typically performed normally so it is not a true case of dysphagia but it can become quite irritating It is common with 22 45 of people experiencing it at least once in their lifetime 1 2 Globus pharyngeusOther namesGlobus pharyngeus globus sensation globus globus hystericus lump in one s throatSpecialtyENT surgery Contents 1 Causes 2 Diagnosis 2 1 Differential diagnosis 3 Management 4 References 5 External linksCauses editThe lump in the throat sensation that characterizes globus pharyngis is often caused by inflammation of one or more parts of the throat such as the larynx or hypopharynx due to cricopharyngeal spasm gastroesophageal reflux GERD laryngopharyngeal reflux or esophageal versatility 3 failed verification In some cases the cause is unknown and symptoms may be attributed to a psychogenic cause i e a somatoform or anxiety disorder It has been recognised as a symptom of depression which responds to anti depressive treatment 4 5 The results of recent studies have strongly suggested that GERD is a major cause of globus though this remains under considerable debate 6 A less common cause distinguished by a lump in the throat accompanied with clicking sensation and considerable pain when swallowing may be due to thyroid cartilage rubbing against anomalous asymmetrical laryngeal anatomy e g the superior cornu abrading against the thyroid lamina 7 8 surgically trimming the offending thyroid cartilage provides immediate relief in all cases 3 However this cause is frequently misdiagnosed despite requiring a simple clinical examination involving careful palpation of the neck side to side which elicits the same click sensation laryngeal crepitus and pain as when swallowing most cases are due to prior trauma to the neck 3 High resolution computed tomographic CT or MRI scan of the larynx is usually required to fully understand the anomalous laryngeal anatomy Anterior displacement of the thyroid ala on the affected side while swallowing can help resolve symptoms citation needed Other anomalous laryngeal anatomy with the potential to cause the globus sensation include thyroid nodules or parathyroid adenomas 9 Diagnosis editAs globus sensation is a symptom a diagnosis of globus pharyngis is typically a diagnosis of exclusion If globus sensation is presenting with other symptoms such as pain swallowing disorders such as aspiration or regurgitation dysphagia weight loss or voice change 10 an organic cause needs to be investigated typically with endoscopy Barium swallows are not recommended as a diagnostic tool as although they are less invasive than endoscopy and may be reassuring to the patient they commonly miss sinister causes It is very rare that globus sensation presenting with no other symptoms has a sinister cause and therefore endoscopy is not recommended in this case 10 11 Differential diagnosis edit Differential diagnosis must be made from Eagle syndrome which uses the patient s description of something caught in my throat as a diagnostic tool Eagle syndrome is an elongation of the styloid process causing irritation to nerves and muscles in the region resulting in a number of unusual symptoms citation needed Management editReassurance of the patient is recommendable when no cause can be found If a cause is identified treat the cause symptomatically or if possible systemically citation needed References edit Robson KM Lembo AJ Globus Sensation UpToDate Retrieved 2019 08 31 Jones D Prowse S October 2015 Globus pharyngeus an update for general practice The British Journal of General Practice 65 639 554 55 doi 10 3399 bjgp15X687193 PMC 4582871 PMID 26412835 a b c Smith ME Berke GS Gray SD Dove H Harnsberger R September 2001 Clicking in the throat cinematic fiction or surgical fact Archives of Otolaryngology Head amp Neck Surgery 127 9 1129 31 doi 10 1001 archotol 127 9 1129 PMID 11556866 Cybulska EM 1997 Globus hystericus a somatic symptom of depression The role of electroconvulsive therapy and antidepressants Psychosomatic Medicine 59 1 67 69 doi 10 1097 00006842 199701000 00009 PMID 9021868 S2CID 24181148 Cybulska EM August 1998 Globus hystericus or depressivus Hospital Medicine 59 8 640 41 PMID 9829059 Lee BE Kim GH May 2012 Globus pharyngeus a review of its etiology diagnosis and treatment World Journal of Gastroenterology 18 20 2462 71 doi 10 3748 wjg v18 i20 2462 PMC 3360444 PMID 22654443 Nadig SK Uppal S Back GW Coatesworth AP Grace AR July 2006 Foreign body sensation in the throat due to displacement of the superior cornu of the thyroid cartilage two cases and a literature review The Journal of Laryngology and Otology 120 7 608 09 doi 10 1017 S0022215106001125 PMID 16681864 S2CID 20575227 Lin D Fischbein N Eisele DW 2005 Odynophagia secondary to variant thyroid cartilage anatomy Dysphagia 20 3 232 34 doi 10 1007 s00455 005 0012 2 PMID 16362512 S2CID 8595093 Srikantha Luxman Amjad Esmael H Beydoun Rafic 2020 12 29 Sudden Odynophagia and Globus A Unique Presentation of a Nonsecreting Parathyroid Adenoma A Case Report and Literature Review Case Reports in Otolaryngology 2020 6805805 doi 10 1155 2020 6805805 ISSN 2090 6765 PMC 7785386 PMID 33457030 a b Kortequee S Karkos PD Atkinson H Sethi N Sylvester DC Harar RS et al 2013 Management of globus pharyngeus International Journal of Otolaryngology 2013 946780 doi 10 1155 2013 946780 PMC 3725834 PMID 23935629 Manabe N Tsutsui H Kusunoki H Hata J Haruma K 2014 Pathophysiology and treatment of patients with globus sensation from the viewpoint of esophageal motility dysfunction Journal of Smooth Muscle Research Nihon Heikatsukin Gakkai Kikanshi 50 66 77 doi 10 1540 jsmr 50 66 PMC 5137314 PMID 26081369 External links edit Globus Sensation Myasthenia gravis and globus information patient info Retrieved 29 April 2018 Retrieved from https en wikipedia org w index php title Globus pharyngis amp oldid 1189807873, wikipedia, wiki, book, books, library,
