Efficacy of auricular vagus nerve stimulation for globus pharyngeus: A prospective pilot study

Globus pharyngeus (persistent "lump in the throat" sensation) is a common, often benign condition with unclear etiology and limited treatment options. This study aimed to evaluate the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing globus symptoms in affected patients.

We conducted a prospective single-arm trial at a tertiary care center. Adult patients with GP received taVNS therapy once daily for 30 min over a two-week period. Stimulation was delivered via an electrode placed on the auricular branch of the vagus nerve. Symptom severity was assessed using the Laryngopharyngeal Measure of Perceived Sensation (LUMP) questionnaire. Anxiety and depression were assessed using the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Pre- and post-treatment scores were compared using paired nonparametric or t-tests, as appropriate. Subgroup analyses were conducted in patients with baseline anxiety or depression, defined as a SAS or SDS score ≥ 50.

A total of 35 patients completed the trial (mean age 51.4 ± 10.9 years), of whom 28 (80 %) were female. All patients tolerated the taVNS protocol well, and no serious adverse effects were reported. There was a significant reduction in globus symptom severity following treatment: the median LUMP score decreased from 10 (IQR 7.5-15) at baseline to 5 (IQR 3-9) post-treatment (p < 0.001). Mean anxiety and depression scores also decreased (SAS: 46.0 ± 8.4 to 43.0 ± 7.7, p = 0.002; SDS: 49.5 ± 11.7 to 44.7 ± 9.4, p = 0.005). Subgroup analyses indicated that mood-related improvements were confined to participants with baseline anxiety (-5.6 points; p = 0.008) or depression (-9.3 points; p = 0.001), while no significant changes were observed in those without baseline emotional symptoms.

taVNS significantly reduced globus pharyngeus symptoms and improved anxiety and depression scores, especially in patients with baseline emotional distress. These findings support the potential of taVNS as a well-tolerated neuromodulation approach for managing globus and warrant further validation in controlled trials.