Study on the function of pharynx upper esophageal sphincter in globus hystericus.

ABSTRACT

AIM: Globus pharyngeus is not an uncommon symptom. Presently, its unclear dated pathophysiology remains unclear and the disease can not be evaluated correctly with routine diagnostic methods. The objective of this study is to establish the normal values of pharyngeal and UES pressure, pharyngeal transit time in healthy volunteers and to compare the differences between healthy volunteers and patients with globus pharyngeus. METHODS: Twenty-four healthy volunteers and thirty-two patients clinically diagnosed as globus pharyngeus entered the study. Pressures of pharynx and UES were measured. Pharyngeal transit time was measured by videofluoroscopic procedure. RESULTS: Normal pressure of pharynx, and normal resting pressure of UES were 157.81+/-63.86 mmHg and 68.33+/-37.56 mmHg, respectively. The corresponding values in the patients were 175.50+/-93.47 mmHg and 71.38+/-41.42 mmHg. The pharyngeal transit time was 1.44+/-0.30 s in normal control group, among them there were 4 cases with stasis of barium in the valleculae and one in the piriform sinus. No laryngeal penetration or aspiration was found. In the patient group, the pharyngeal transit time was 1.37+/-0.41 s, among them there were 6 cases with stasis of barium in the valleculae and 5 in the piriform sinus. 9 cases had laryngeal penetration and 2 had aspiration. There were no statistical differences of pressures of pharynx, UES and the pharyngeal transit time between the two groups. But there was an association between laryngeal penetration and globus pharyngeus. CONCLUSION: Radiographic examination of the pharynx show specific findings of pharyngeal dysfunction in patients with globus pharyngeus. UES pressure is normal in most patients. Hence, we find no role for UES hypertonicity as an etiologic factor in globus pharyngeus.