A Differentiated Approach to Patients With Globus Sensations: Assessing the Value of Diagnostic Procedures and Tailored Therapy.

OBJECTIVE

This study aimed to assess the efficacy of a comprehensive diagnostic approach (including meticulous clinical examination, neck ultrasound, and pH monitoring methods) and targeted therapeutic interventions in patients presenting with unclear globus sensations.

STUDY

DESIGN

Prospective cross-sectional single-center study

METHODS

Patients (n = 80) presenting with globus sensations underwent comprehensive ear nose throat examination, neck sonography, and ambulatory 24-hour double-probe pH monitoring to assess acid exposure in the distal esophagus and hypopharynx. Participants completed the Reflux Symptom Index (RSI) and Glasgow Edinburgh Throat Scale (GETS) questionnaires to establish baseline symptom severity and assess treatment response after three months. Patients with an identified local organic etiology received surgical intervention, while those with confirmed acid reflux disease were prescribed a proton pump inhibitor (PPI) (pantoprazole) for 3 months. Patients lacking clear organic causes or signs of reflux disease received guidance on modifying their lifestyle and were scheduled for follow-up evaluation after three months. Treatment response was defined as >50% reduction in symptom scores between the two assessments.

RESULTS

Potential causes were identified in 78.8% of patients, with acid reflux disease being the most prevalent (47.5%), followed by local organic pathology (31.3%). Following tailored treatments, patients demonstrated significant improvement in all three groups (P < 0.001), with 70% meeting the criteria for treatment response. The presence of acid reflux disease was a significant independent pretreatment factor for predicting the 12-week treatment response (P = 0.002).

CONCLUSIONS

This study emphasizes the importance of a systematic diagnostic protocol that allows for more targeted and effective treatment in a sensitive population of patients with globus sensations.