Globus pharyngeus a diagnostic challenge for otolaryngologist

<p class="abstract"><strong>Background:</strong> Globus pharyngeus, also known as globus sensation, can be defined as the sensation of a lump or foreign body in the absence of a mass on examination. The disorder is frequently linked to catarrh, hoarseness, chronic cough and persistent throat clearing. Globus pharyngeus accounts for 4 percent of ENT (ear, nose and throat) referrals. The exact cause of globus pharyngeus is unknown. The presence of lingual tonsil, cricopharyngeal spasm, hiatus hernia, cervical osteophytosis, sinusitis, gastro-oesophageal reflux, goiter post-nasal drip and anxiety have all been shown as associations in the literature. Digestive enzymes and regurgitation of stomach acid are thought to cause persistent inflammation, for example, of the laryngopharynx, which causes symptoms. Reflux has been depicted in 23-68 percent of patients with globus sensation. Notably, some studies claim that asymptomatic control patients have a similar rate.</p><p class="abstract"><strong>Methods:</strong> We presented our audit study of 50 subsets of patients. It was considered that gastro-oesophageal reflux was the reason; however, it cannot explain all the potential causes.</p><p class="abstract"><strong>Results:</strong> Barium swallow was found to be a very key diagnostic tool in this group of patients.</p><p class="abstract"><strong>Conclusions:</strong> Panendoscopy in globus sensation in the throat, looking through the possible causes of globus sensation, current trends and diagnosis as well as methods of treatment.</p>

Medical and psychiatric differential diagnoses of pediatric globus sensation: A case study with review discussion

Globus hystericus, also known as globus pharyngeus or globus sensation, is characterized by the physical sensation of a mass in one’s throat. Globus sensation is more common in adults and reported more rarely in children. Adult patients with globus sensation score higher on neuroticism, introversion, anxiety, and depression. However, not all patients with globus sensation have psychiatric abnormalities. Thus, it is important to share an atypical presentation in children and highlight the necessity of ruling out other organic causes. The present case study elucidates the process of ruling out medical etiologies of globus sensation in a young girl with anxiety and food aversion. We provide a review discussion of the differential diagnoses, both medical and psychiatric, of globus sensation in the pediatric population reported in past literature. The case study and review of pediatric globus sensation shows that the symptom can be associated with a wide array of psychological and medical diagnoses. The medical differential diagnoses of globus sensation include the gastroenteric system, laryngeal system, cardiovascular system, and nervous system. We encourage critical analysis of other potential diagnoses, given each patient’s unique history and physical presentation.

Giant Fibrovascular Polyp as an Unusual Cause of Globus Pharyngeus

Differential diagnosis of globus sensation in an otherwise asymptomatic patient should include hypopharyngeal fibrovascular polyp to avoid potentially fatal complications like airway compromise following regurgitation. We present a case of a 74-year-old man with a 13-cm long hypopharyngeal fibrovascular polyp with 9 months history of globus sensation. A narrow stalk of the giant polyp allowed endoscopic removal and complete resection with the CO2 laser. Histopathological examination was conclusive for the fibrovascular polyp.

Characteristics Of Patient With Foreign Body Ingestion In Palembang

Introduction. Foreign body ingestion is a common diagnosis that presents in emergency departments—coins as the oesophagal foreign body most commonly found in infants and children. Coins retained in the oesophagus require intervention to prevent complications. This study aimed to determine oesophagal coin foreign body patient's characteristic at Mohammad Hoesin General Hospital Palembang. Method. This study design was retrospective descriptive. Samples were all patient diagnosed with oesophagal coin foreign bodies which underwent Extraction with esophagoscopy guidance that was performed at Mohammad Hoesin General Hospital Palembang during January 2013 – August 2017. Result. Forty-three patients had diagnosed with oesophageal coin foreign bodies consist of 22 males and 21 females. The most frequent age was 4fouryears old. The most presenting symptoms are Globus sensation on the throat (79%) and odynophagia (51,1%). Radiologist confirmation was done in every patient with foreign coin bodies in oesophagus. All patients underwent oesophagoscopy. 65,1% of cases of foreign coin bodies were found in the second constriction of throat. Duration of stay in hospital was the range from 1- 4 days, with the most frequent, was two days. There was no complication found in all patients. Conclusion. Oesophagal coin foreign body is most commonly ingested in children. The most presenting symptom is globus sensation on the throat. There is no complication found in this study.

Acquired tracheoesophageal fistula in disseminated Mycobacterium avium complex associated with anti-interferon-gamma autoantibodies

We describe a case of a 30-year-old previously healthy woman who presented to our hospital with a 2-month history of fevers, tender lymphadenopathy, dysphagia, globus sensation and occasional haematemesis. Further evaluation revealed cervicothoracic adenopathy and a subcarinal mass with oesophageal involvement. Imaging showed a transesophageal fistula at the level of the carina with contrast extravasation to the left main bronchus. Our patient was diagnosed with disseminated Mycobacterium avium complex (MAC) based on acid-fast bacillus noted on sputum cultures and nodal biopsies. Further investigation revealed anti-interferon-gamma autoantibodies as a possible predisposing factor for the disseminated MAC infection. This case demonstrates the importance of a broad differential diagnoses in a patient presenting with unexplained cervicothoracic lymphadenopathy, fever and dysphagia. Although acquired tracheoesophageal fistulae are uncommon, it should be considered in the clinical setting of globus sensation, haemoptysis and dysphagia. Furthermore, our case highlights a rare predisposition to disseminated Mycobacterium infection.