Woo P, Noordzij P, Ross J A
Department of Otolaryngology-Head and Neck Surgery, New England Medical Center, Boston, MA 02111, USA.
Otolaryngol Head Neck Surg. 1996 Dec;115(6):502-7. doi: 10.1016/S0194-59989670003-7.
Thirty-one patients with globus sensation were examined by dual probe pH manometry and videolaryngoscopy to investigate the role of gastroesophageal reflux disease in association with globus. Abnormal laryngeal findings, which included grossly abnormal and subtle changes, were seen in 17 patients. These findings included pharyngeal erythema (12 patients), interarytenoid pachydermia (11), laryngeal edema (11), arytenoid erythema (9), and thick mucus (3). Twenty-one of the 31 pH probe studies showed gastroesophageal reflux disease (14 grossly abnormal, 6 borderline abnormal) with Johnson and DeMeester composite scores for the distal probe. There was no correlation between the upright and supine position, nor was there correlation between positive laryngeal findings and a positive pH probe study. We conclude that globus sensation is often a nonspecific symptom of laryngopharyngeal irritation in which gastroesophageal reflux disease plays a significant role. Combining careful laryngoscopic examination with pH probe studies can help to differentiate between patients with organic pathology caused by gastroesophageal reflux disease and patients with other nonspecific laryngopharyngeal disorders.
对31例有咽部异物感的患者进行了双探头pH测压和视频喉镜检查，以研究胃食管反流病与咽部异物感的关系。17例患者出现喉部异常表现，包括明显异常和细微变化。这些表现包括咽部红斑（12例）、杓间区肥厚（11例）、喉部水肿（11例）、杓状软骨红斑（9例）和浓稠黏液（3例）。31例pH探头研究中有21例显示胃食管反流病（14例明显异常，6例临界异常），采用远端探头的约翰逊和德梅斯特综合评分。直立位和仰卧位之间无相关性，喉部阳性表现与pH探头研究阳性之间也无相关性。我们得出结论，咽部异物感通常是喉咽刺激的非特异性症状，其中胃食管反流病起重要作用。将仔细的喉镜检查与pH探头研究相结合有助于区分由胃食管反流病引起的器质性病变患者和其他非特异性喉咽疾病患者。
