Globus pharyngis: Development of a symptom assessment scale

doi:10.1016/0022-3999(94)00104-D

Journal of Psychosomatic Research

Volume 39, Issue 2, February 1995, Pages 203-213

https://doi.org/10.1016/0022-3999(94)00104-D Get rights and content

Abstract

One hundred and five consecutive patients attending an ENT out-patients' clinic with a diagnosis of globus pharyngis completed a 10-item questionnaire concerning common throat symptoms. Principal components analysis of the questionnaire revealed a general throat pathology factor, and three orthogonal rotated factors which were related to dysphagia, globus sensation, and pain/swelling in the throat. Of 10 throat symptoms, the globus patients most commonly complained of: “Feeling of something stuck in the throat,” “Discomfort/irritation in the throat,” and “Want to swallow all the time.” These were the symptoms which had highest loadings on the ‘globus’ factor. The clear factor structure and the satisfactory internal consistency of the Glasgow-Edinburgh Throat Scale (GETS) suggest that it offers a clinically useful instrument for assessing and monitoring the severity of some common throat ailments. The degree of distress caused by throat symptoms was predicted independently by the intensity of the globus sensation and by anxiety level.

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Citation Excerpt :
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The Persian version of RSS-12 is a valid and reliable self-administered questionnaire for assessing LPRD in Persian-speaking patients.
Is there Really a Lump in My Throat? The Incidence and Implication of Vocal fold Abnormalities in Patients Presenting with Globus
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To identify the prevalence of vocal fold abnormalities in patients with a primary complaint of globus sensation. Secondly, to determine the relationship between globus, vocal fold abnormality, and patient-reported quality of life questionnaire score.
Retrospective chart review.
A retrospective chart review was performed to identify all new patients evaluated at a tertiary academic care laryngology practice between January 2018 and December 2018 presenting with a chief complaint of globus. Variables of interest include age, gender, laryngeal symptoms, self-reported quality-of-life questionnaire results, and laryngostroboscopy findings. Questionnaires selected for this investigation include the reflux symptom index (RSI), eating assessment tool-10 (EAT-10), and voice handicap index-10 (VHI-10).
Two hundred twenty-eight subjects with an average age of 54 ±17 years, were categorized based on one of three laryngostroboscopic findings: absence of vocal fold abnormality, vocal fold paresis/paralysis (motion abnormality), or a vocal fold mass lesion. Fifty percent of patients reporting globus had a normal laryngeal exam, and 50% had a mass lesion or motion abnormality. Twenty five percent had vocal fold motion abnormality (paresis, paralysis, or supraglottic squeeze); 19% had a mass lesion; and 3% had both a lesion and motion abnormality. The average self-reported survey scores were compared among the three groups. Patients with dysphonia had a significantly higher VHI-10 (P = 0.00), and a significantly higher RSI (P = 0.00) than those without dysphonia. Those patients with dysphagia had significantly higher EAT-10 (P = 0.00) and RSI (P = 0.02) scores than those who did not have dysphagia. Patients with vocal fold motion abnormality had significantly higher VHI-10 than those with normal vocal fold mobility (P = 0.02)
Identifying the etiology of globus presents a significant challenge to laryngologists. Data presented here suggest that vocal fold abnormalities may contribute to the sensation of globus and should therefore be considered in the differential when managing these patients.
Persian Translation, Validation and Reliability of the Voice Handicap Index-Throat (VHI-T)
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The aim of the present study is to validate, and assess the reliability of the Persian version of Voice Handicap Index-Throat (VHI-Tp) as a self-reported questionnaire for patients with throat problems that could make the patients' estimation of the throat discomforts possible. It is a subscale to be used independently.
This is a cross-sectional study.
During this study, the VHI-Tp was administered to120 patients with throat problems related to laryngeal discomfort (51 male and 69 female, age range: 30–60 years).The diagnosis of Voice disorder was performed by an ENT physician based on video-laryngoscopy evidences and medical examination. To assess the content validity, the questions were first given to 15 experts to comment on content applicability and relevance through a Likert scale. Eighty patients rated its importance to detect face validity. To evaluate the concurrent validity, the same 80 patients completed both the VHI-Tp as well as the Persian version of Voice Symptom Scale. The VHI-Tp total scores of the patients with diagnosed throat problem related to laryngeal discomfort and of the 40 healthy participants were compared to test the clinical validity (discriminant validity). Also, internal consistency reliability was assessed using Cronbach α coefficient. The relative reliability was calculated by asking 40 of all patients out of the 80 participants, to complete the VHI-Tp twice, with a week of interval between the first and the second times. To detect the absolute reliability, Standard Error of Measurement and Smallest Detected Change were calculated.
Discriminative validity differed significantly between patients and healthy participants. There was a significant correlation between the VHI-Tp and Voice Symptom Scale total scores (r = 0.6, P < 0.05). The internal consistency was confirmed (Cronbach α = 0.78). The test-retest reliability was excellent (intraclass correlation coefficient = 0.95).The Standard Error of Measurement and Smallest Detected Changes were acceptable (0.39 and 1.08), respectively.
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Original paperGlobus pharyngis: Development of a symptom assessment scale

Abstract

Chest

J Psychosom Res

Psychosomatic Syndromes and Somatic Symptoms

The concept of hysteria in the time of William Harvey

The importance of hysteria

Br J Psychiatry

The globus symptom

Arch Otolaryngology

Hypertrophied lingual tonsils

Laryngoscope

‘Globus hystericus’ and tonsils

Practitioner Otorhinolaryngology (Basel)

Studies on abnormal feeling in the throat

Practitioner Otorhinolaryngology (Basel)

A ‘lump’ in the throat

J Laryngology Otology

Cervical osteophytes presenting with pharyngeal symptoms

Laryngoscope

Globus sensation is not caused by gastro-oesophageal reflux

Clin Otolaryngology

Pharyngoesophageal dysmotility in globus sensation

Arch Otolaryngology Head Neck Surg

Globus hystericus (globus sensation)

N Engl J Med

Clinical aspects of pseudodysphagia

J Laryngology Otology

Original paper
Globus pharyngis: Development of a symptom assessment scale