Relationship between globus sensation and esophageal clearance.
CONCLUSIONS
Videofluoroscopy (VF) in the prone position can diagnose a range of esophageal pathologies in all age groups. These correlate with globus sensation in younger and middle-aged patients in prone and supine positions. Abnormal esophageal clearance appears to be associated with globus sensation in young and middle-aged persons, but not in the elderly.


OBJECTIVE
To assess the correlation between globus sensation and abnormal esophageal clearance by VF in relation to body position and to investigate age-related abnormal esophageal clearance, as well as to confirm the utility of VF in diagnosing globus sensation in patients.


METHODS
This was a prospective study. In 72 patients with globus sensation and 33 controls, esophageal clearance was assessed by VF in the upright, supine, and prone positions, and transfer of barium through the esophagus was classified as normal, esophageal retention, esophageal reflux, or pharyngeal reflux. The detection rate of abnormal esophageal clearance was compared among all subjects by age.


RESULTS
In the upright position, VF detected no significant differences in the detection rate of abnormal esophageal clearance and reflux between the patients with globus sensation and controls; however, the detection rate of abnormal esophageal clearance was significantly higher in the prone than in the upright and supine positions (p<0.001), and in all positions was significantly higher among globus sensation patients (p<0.05). In the supine and prone positions, there were significantly higher detection rates of abnormal esophageal clearance in patients than in controls in the young group (p<0.05). Additionally in the prone position, there was a significantly higher detection rate of abnormal esophageal clearance and reflux in patients than in controls in the middle-aged group (p<0.05). In all positions, no significant differences were observed in the detection rate of abnormal esophageal clearance and reflux in the patients and controls in the elderly group.
Adachi
Jin
J
Department of Otolaryngology, National Defense Medical College, Tokorozawa, Japan. jinadachi@yahoo.co.jp
Ohmae
Yukio
Y
Karaho
Takehiro
T
Tanabe
Tetsuya
T
Mizokami
Daisuke
D
Hirota
Kouji
K
Tomifuji
Masayuki
M
Kurita
Akihiro
A
Matsunobu
Takeshi
T
Shiotani
Akihiro
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D003291:Conversion Disorder / Q000175:diagnosis* / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy / Q000295:instrumentation*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D011446:Prospective Studies; D012016:Reference Values; D016683:Supine Position; D014741:Video Recording / Q000295:instrumentation*
D003287:Contrast Media; D001466:Barium Sulfate