Järvenpää Pia, Ilmarinen Taru, Geneid Ahmed, Pietarinen Petra, Kinnari Teemu J, Rihkanen Heikki, Ruohoalho Johanna, Markkanen-Leppänen Mari, Bäck Leif, Arkkila Perttu, Aaltonen Leena-Maija
Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 263, FI-00029 HUS, Helsinki, Finland.
Department of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):931-937. doi: 10.1007/s00405-016-4307-8. Epub 2016 Sep 17.
Globus patients with normal ear, nose, and throat (ENT) status are a diagnostic challenge. The symptom may be long lasting and cause concern about malignancy, leading to possibly unnecessary further investigation. The aim of the study was to assess whether radiological examinations are useful in globus diagnostics, how often patients suffer from persistent globus, and whether globus patients with normal ENT status develop a malignancy during a follow-up. We reviewed medical records of all 76 globus patients referred to Helsinki University Hospital, Department of Otorhinolaryngology-Head and Neck Surgery in 2009. Patient history and findings in physical and radiological examinations were registered. A questionnaire concerning patients' present pharyngeal symptoms was sent 3 and 6 years after their initial visit. Data from the Finnish Cancer Registry revealed whether patients developed malignancies within a 3-year follow-up. Based on medical records, neck ultrasound was performed for 37 (49 %) and videofluorography for 22 patients (29 %), with nonsignificant findings. After a 3- and 6-year follow-up, half patients indicated that they were asymptomatic or had fewer symptoms, whereas the rest had persistent symptoms. The Finnish Cancer Registry data confirmed that globus patients developed no head and neck malignancies during a 3-year follow-up. In the present study, neck ultrasound and videofluorography showed no additional benefit to evaluate the globus etiology in patients whose ENT status was normal. Half the globus patients suffered from persistent symptoms after a 3- and 6-year follow-up, indicating that globus may cause discomfort chronically. However, no patients developed malignancies during a 3-year follow-up.
耳鼻咽喉（ENT）状况正常的咽异感症患者是一个诊断难题。该症状可能持续很长时间，并引发对恶性肿瘤的担忧，从而可能导致不必要的进一步检查。本研究的目的是评估放射学检查在咽异感症诊断中是否有用，患者持续性咽异感症的发病频率如何，以及耳鼻咽喉状况正常的咽异感症患者在随访期间是否会发生恶性肿瘤。我们回顾了2009年转诊至赫尔辛基大学医院耳鼻咽喉-头颈外科的所有76例咽异感症患者的病历。记录了患者病史以及体格检查和放射学检查结果。在患者初次就诊3年和6年后，发送了一份关于患者当前咽部症状的问卷。芬兰癌症登记处的数据显示了患者在3年随访期间是否发生恶性肿瘤。根据病历，37例患者（49%）进行了颈部超声检查，22例患者（29%）进行了视频透视检查，结果均无明显异常。经过3年和6年的随访，一半的患者表示无症状或症状减轻，而其余患者仍有持续性症状。芬兰癌症登记处的数据证实，咽异感症患者在3年随访期间未发生头颈恶性肿瘤。在本研究中，颈部超声和视频透视检查对评估耳鼻咽喉状况正常的咽异感症患者的病因没有额外帮助。经过3年和6年的随访，一半的咽异感症患者仍有持续性症状，这表明咽异感症可能会长期引起不适。然而，在3年随访期间没有患者发生恶性肿瘤。
