Chevalier Julia M, Brossard Edgar, Monnier Philippe
Service d'ORL et chirurgie cervico-faciale, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Eur Arch Otorhinolaryngol. 2003 May;260(5):273-6. doi: 10.1007/s00405-002-0544-0. Epub 2002 Nov 12.
Recent studies suggest that gastroesophageal reflux disease (GERD) may be a major cause of globus sensation. However, the incidence and severity of GERD in patients with globus sensation without reflux symptoms are unknown. In order to establish the relationship between globus sensation in the jugular fossa and GERD, 20 patients attending our ear, nose and throat (ENT) outpatient clinic with globus sensation were investigated with 24-h pH monitoring. A four-channel pH catheter was used with the pH electrodes spaced 5 cm apart in order to detect reflux along the whole length of the esophagus. Fifteen patients complained about globus sensation only; five patients complained additionally about classical reflux symptoms. Thirteen patients showed pathologic reflux measurements. Most of the patients had reflux limited to the distal one-third of the esophagus. Patients with pathologic pH measurements were treated with proton pump inhibitors. Ten out of 13 patients improved with treatment. This study suggests that globus may be associated with reflux, and acidity does not have to reach the pharynx to produce globus sensation.
近期研究表明,胃食管反流病(GERD)可能是导致咽部异物感的主要原因。然而,无反流症状的咽部异物感患者中GERD的发病率及严重程度尚不清楚。为明确颈静脉窝处咽部异物感与GERD之间的关系,对20名因咽部异物感前来我院耳鼻喉科门诊就诊的患者进行了24小时pH监测。使用四通道pH导管,pH电极间距为5厘米,以检测食管全长的反流情况。15名患者仅主诉有咽部异物感;5名患者还主诉有典型的反流症状。13名患者的反流测量结果显示异常。大多数患者的反流局限于食管远段三分之一处。对pH测量结果异常的患者使用质子泵抑制剂进行治疗。13名患者中有10名经治疗后症状改善。本研究提示,咽部异物感可能与反流有关,且酸度不一定到达咽部即可产生咽部异物感。