Globus sensation: findings on videofluoroscopic examinations

To determine the findings on videofluoroscopy of the pharynx and esophagus in patients with a globus sensation and compare them with a similar group of patients with dysphagia.

A computerized search of radiology files revealed 83 patients with a globus sensation who had videofluoroscopic examinations of the pharynx and esophagus during a 10-year period from 1989-1999. A computerized search was also performed to generate an age- and sex-matched group of 83 patients with dysphagia who also had videofluoroscopic examinations during this period. Original radiologic reports were reviewed to determine the frequency of morphologic and functional abnormalities of the pharynx and esophagus in these 2 groups.

Early closure of the cricopharyngeus was found in 13 (16%) patients with globus versus 2 (2%) with dysphagia (p < 0.01). Enlarged pharyngeal tonsils were found in 31 (37%) patients with globus versus 17 (21%) with dysphagia (p < 0.05). Enlarged lingual tonsils were characterized on barium studies by nodularity or lobulation of the posterior-inferior base of the tongue and valleculae in all patients, and the palatine tonsils were symmetrically enlarged in all but 2 patients. No other radiographic findings were significantly associated with a globus sensation.

Early closure of the cricopharyngeus and enlarged lingual or palatine tonsils may contribute to the development of a globus sensation, but the pathophysiologic basis for this association remains unclear.