Rigid endoscopy in globus pharyngeus: how valuable is it?

Area of Science:

• Otolaryngology
• Gastroenterology

Background:

• Globus sensation, a common complaint, prompts investigations into potential underlying causes.
• The diagnostic yield of rigid endoscopy for globus symptoms requires evaluation.

Purpose of the Study:

• To assess the diagnostic value of rigid endoscopy in patients presenting with globus symptoms.
• To determine the prevalence of significant pathological findings in this patient group.

Main Methods:

• Retrospective analysis of 250 patients undergoing rigid endoscopy for globus symptoms over 12 months.
• Statistical analysis, including chi-square test, to correlate clinical diagnosis with endoscopic findings.

Main Results:

• A high rate (86.8%) of normal findings in the larynx, pharynx, and upper esophagus.
• Abnormal findings were infrequent, including cricopharyngeal spasm (4.8%), reflux (4.4%), and other minor conditions.
• The 95% confidence interval for malignancy was low (0-3.7 per 1000), with a highly significant p-value (0.0001) for the relationship between diagnosis and findings.

Conclusions:

• Rigid endoscopy for globus sensation is unlikely to identify neoplastic lesions.
• The investigation may be inappropriate for most patients with globus symptoms, given the low diagnostic yield.
• Avoiding rigid endoscopy can prevent associated risks, costs, and patient discomfort.