title: The Role of the Modified Barium Swallow Study and Esophagram in Patients with Globus Sensation.
abstract: Globus sensation (GS) is a common benign finding that is often associated with frequent throat clearing and is commonly a result of laryngopharyngeal reflux. The primary objective of this investigation was to examine the role of the modified barium swallow study (MBSS) with esophagram in the diagnosis and management patients who present with chief complaints of a GS. We hypothesize that these radiographic swallow studies do not add clinically significant information in the investigation of this common complaint. Retrospective chart review of patients with chief complaints of GS between 2000 and 2009 who underwent both MBSS and esophagram was conducted. Of the 380 patients who underwent MBSS, only 68 patients were eligible for this study. Over 70 % of patients were on reflux medicines, 81 % of the MBSS studies were normal, 62 % of the esophagram results were normal, 18 % of patients had a hiatal hernia, and 10 % exhibited signs of reflux. Esophagoscopy was performed in 45 % of patients, of which 35 % were normal. One patient initially had a normal esophagogastroduodenoscopy and then was subsequently diagnosed with gastric CA. Fifty-nine percent of patients underwent CT Neck with IV contrast, of which 67 % had minor findings. Positive findings are often benign and can be treated with reflux medications. Esophagoscopy was often normal and most sensitive only for hiatal hernia. No hypopharyngeal cancer was noted. Therefore, MBSS and esophagram for patients with GS are most often negative and fail to add significant diagnostic information.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Detroit Medical Center, Harper professional Building, Ste. 1007, 4160 John R, Detroit, MI, 48201, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Dworkin
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Jayme R
authors.initials: JR
authors.lastname: Dowdall
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Kubik
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Detroit Medical Center, Harper professional Building, Ste. 1007, 4160 John R, Detroit, MI, 48201, USA. pthottam@gmail.com.|Department of Otolaryngology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA. pthottam@gmail.com.
authors.forename: Prasad John
authors.initials: PJ
authors.lastname: Thottam
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Folbe
mesh_terms: D001464:Barium; D003679:Deglutition; D016145:Endoscopy, Digestive System; D004947:Esophagus; D006801:Humans; D012189:Retrospective Studies; D012677:Sensation
chemical_list: D001464:Barium
keywords: Deglutition; Esophagogastroduodenoscopy; Esophagram; Gastroesophageal reflux (GERD); Globus sensation