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REVIEW ARTICLES

Globus Pharyngeus: Etiology, Diagnostics and Treatment
Globus Farengeus: Etiyoloji, Tanı ve Tedavisi
Received Date : 05 Sep 2019
Accepted Date : 12 Nov 2019
Available Online : 19 Dec 2019
Doi: 10.24179/kbbbbc.2019-71311 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(3):137-48
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Globus pharyngeus is a non-painful sensation of a lump or a foreign body in the throat. The sensation may occur persistently or intermittently and it frequently improves with eating. Globus like symptoms were first described by the Egyptians around 1900 BC. Currently, various terms like “globus”, “globus pharyngeus”, “globus hystericus”, “pseudodysphagia” and “globus syndrome” are available in literature. The etiology of globus is still unclear and multifactorial reasons are considered. Due to the uncertain etiology, it is difficult to manage the diagnosis and treatment process of globus. This review presents the current literature of globus including its etiology, diagnosis, treatment and also an algorithm for globus management.
ÖZET
Globus farengeus; boğazda yumru veya yabancı cisim hissi şeklinde tarif edilen, ağrısız, sürekli ya da aralıklı zamanlarda ortaya çıkan ve genelde yemek yeme esnasında artış gösteren klinik bir semptomdur. Globus benzeri semptomlar ilk olarak MÖ yaklaşık 1900’lü yıllarda Mısırlılar tarafından tarif edilmiştir. Günümüz literatüründe ise semptomu tariflemek için başta “globus”, “globus pharyngeus”, “globus hystericus”, “pseudodysphagia” ve “globus syndrome” olmak üzere çeşitli tanımlar kullanılmaktadır. Tarihçesi çok eski zamanlara dayanmasına rağmen globus etiyolojisi hâlâ tam olarak bilinmemekte ve multifaktöriyel sebepler öne sürülmektedir. Etiyolojideki bu belirsizlik, standart tanı ve tedavi sürecini de olumsuz etkilemektedir. Bu makalede, globusun etiyolojisine, teşhisine ve tedavisine ait güncel literatür bilgilerinin yanı sıra globus yönetiminde kullanılmak üzere bir algoritmaya yer verilmiştir.
KAYNAKLAR
  1. Moloy PJ, Charter R. The globus symptom. Incidence, therapeutic response, and age and sex relationships. Arch Otolaryngol. 1982;108(11):740-4. [Crossref]  [PubMed] 
  2. Rasmussen ER, Schnack DT, Ravn AT. A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus. Clin Otolaryngol. 2018;43(3):854-60. [Crossref]  [PubMed] 
  3. Galmiche JP, Clouse RE, Bálint A, Cook IJ, Kahrilas PJ, Paterson WG, et al. Functional esophageal disorders. Gastroenterology. 2006;130(5):1459-65. [Crossref]  [PubMed] 
  4. Malcomson KG. Radiological findings in globus hystericus. Br J Radiol. 1966;39(464):583-6. [Crossref]  [PubMed] 
  5. Smith GR Jr. Somatization Disorder in the Medical Setting. 1st ed. Rockville, Maryland: American Psychiatric Pub; 1991. p.98.
  6. Malcomson KG. Globus hystericus vel pharyngis (a reconnaissance of proximal vagal modalities). J Laryngol Otol. 1968;82(3):219-30. [Crossref]  [PubMed] 
  7. Purcell J. A treatise of vapours, or hysterick fits. Containing an analytical proof of its causes, mecanical explanations of all its symptoms and accidents, according to the newest and most rational principles. Together with its cure at large. 2nd ed. London: Printed for Edward Place; 1707. p.280.
  8. Doody J, Fenton JE. Troublesome throat awareness (tTA) as a contemporary alternative to 'globus pharyngeus'. Surgeon. 2017;15(4):183-5. [Crossref]  [PubMed] 
  9. Tawil J, Fass R. Globus: current consepts and dilemmas. J Clin Gastroenterol. 2018;52(10):845-52. [Crossref]  [PubMed] 
  10. Corso MJ, Pursnani KG, Mohiuddin MA, Gideon RM, Castell JA, Katzka DA, et al. Globus sensation is associated with hypertensive upper esophageal sphincter but not with gastroesophageal reflux. Dig Dis Sci. 1998;43(7):1513-7. [Crossref]  [PubMed] 
  11. Färkkilä MA, Ertama L, Katila H, Kuusi K, Paavolainen M, Varis K. Globus pharyngis, commonly associated with esophageal motility disorders. Am J Gastroenterol. 1994;89(4):503-8.
  12. Wilson J, Heading R, Maran A, Pryde A, Piris J, Allan P. Globus sensation is not due to gastro‐oesophageal reflux. Clinical Otolaryngology & Allied Sciences. 1987;12(4):271-5. [Crossref]  [PubMed] 
  13. Chevalier JM, Brossard E, Monnier P. Globus sensation and gastroesophageal reflux. Eur Arch Otorhinolaryngol. 2003;260(5):273-6. [Crossref]  [PubMed] 
  14. Wilson JA, Pryde A, Piris J, Allan PL, Macintyre CC, Maran AG, et al. Pharyngoesophageal dysmotility in globus sensation. Arch Otolaryngol Head Neck Surg. 1989;115(9):1086-90. [Crossref]  [PubMed] 
  15. Cherry J, Siegel CI, Margulies SI, Donner M. Pharyngeal localization of symptoms of gastroesophageal reflux. An Otol Rhinol Laryngol. 1970;79(5):912-5. [Crossref]  [PubMed] 
  16. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24‐hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101(4 Pt 2 Suppl 53):1-78. [Crossref]  [PubMed] 
  17. Ford CN. Evaluation and management of laryngopharyngeal reflux. JAMA. 2005;294(12):1534-40. [Crossref]  [PubMed] 
  18. Park KH, Choi SM, Kwon SU, Yoon SW, Kim SU. Diagnosis of laryngopharyngeal reflux among globus patients. Otolaryngol Head Neck Surg. 2006;134(1):81-5. [Crossref]  [PubMed] 
  19. Tokashiki R, Funato N, Suzuki M. Globus sensation and increased upper esophageal sphincter pressure with distal esophageal acid perfusion. Eur Arch Otorhinolaryngol. 2010;267(5):737-41. [Crossref]  [PubMed] 
  20. Phua SY, McGarvey LP, Ngu MC, Ing AJ. Patients with gastro-oesophageal reflux disease and cough have impaired laryngopharyngeal mechanosensitivity. Thorax. 2005;60(6):488-91. [Crossref]  [PubMed]  [PMC] 
  21. Tauber S, Gross M, Issing WJ. Association of laryngopharyngeal symptoms with gastroesophageal reflux disease. Laryngoscope. 2002;112(5):879-86. [Crossref]  [PubMed] 
  22. Hicks DM, Ours TM, Abelson TI, Vaezi MF, Richter JE. The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J Voice. 2002;16(4):564-79. [Crossref] 
  23. Gooi Z, Ishman SL, Bock JM, Blumin JH, Akst LM. Laryngopharyngeal reflux: paradigms for evaluation, diagnosis, and treatment. Ann Otol Rhinol Laryngol. 2014;123(10):677-85. [Crossref]  [PubMed] 
  24. Halum SL, Butler SG, Koufman JA, Postma GN. Treatment of globus by upper esophageal sphincter injection with botulinum A toxin. Ear Nose Throat J. 2005;84(2):74. [Crossref] 
  25. Kwiatek MA, Mirza F, Kahrilas PJ, Pandolfino JE. Hyperdynamic upper esophageal sphincter pressure: a manometric observation in patients reporting globus sensation. Am J Gastroenterol. 2009;104(2):289-98. [Crossref]  [PubMed]  [PMC] 
  26. Cook IJ, Dent J, Collins SM. Upper esophageal sphincter tone and reactivity to stress in patients with a history of globus sensation. Dig Dis Sci. 1989;34(5):672-6. [Crossref]  [PubMed] 
  27. Sun J, Xu B, Yuan YZ, Xu JY. Study on the function of pharynx upper esophageal sphincter in globus hystericus. World J Gastroenterol. 2002;8(5):952-5. [Crossref]  [PubMed]  [PMC] 
  28. Choi WS, Kim TW, Kim JH, Lee SH, Hur WJ, Choe YG, et al. High-resolution manometry and globus: comparison of globus, gastroesophageal reflux disease and normal controls using high-resolution manometry. J Neurogastroenterol Motil. 2013;19(4):473-8. [Crossref]  [PubMed]  [PMC] 
  29. Nevalainen P, Walamies M, Kruuna O, Arkkila P, Aaltonen LM. Supragastric belch may be related to globus symptom-a prospective clinical study. Neurogastroenterol Motil. 2016;28(5):680-6. [Crossref]  [PubMed] 
  30. Peng L, Patel A, Kushnir V, Gyawali CP. Assessment of upper esophageal sphincter function on high-resolution manometry: identification of predictors of globus symptoms. J Clin Gastroenterol. 2015;49(2):95-100. [Crossref]  [PubMed]  [PMC] 
  31. Moser G, Vacariu-Granser GV, Schneider C, Abatzi TA, Pokieser P, Stacher-Janotta G, et al. High incidence of esophageal motor disorders in consecutive patients with globus sensation. Gastroenterology. 1991;101(6):1512-21. [Crossref] 
  32. Lei WY, Hung JS, Liu TT, Yi CH, Chen CL. Altered oesophageal mechanosensitivity of secondary peristalsis as a pathophysiological marker in patients with globus sensation. Clin Otolaryngol. 2018;43(1):306-11. [Crossref]  [PubMed] 
  33. Kahrilas PJ, Bredenoord AJ, Fox M, Gyawali CP, Roman S, Smout AJ, et al. The chicago classification of esophageal motility disorders, v3. 0. Neurogastroenterol Motil. 2015;27(2):160-74. [Crossref]  [PubMed]  [PMC] 
  34. Hill J, Stuart RC, Fung HK, Ng EK, Cheung FM, Chung CS, et al. Gastroesophageal reflux, motility disorders, and psychological profiles in the etiology of globus pharyngis. Laryngoscope. 1997;107(10):1373-7. [Crossref]  [PubMed] 
  35. Batch AJ. Globus pharyngeus: (Part II), discussion. J Laryngol Otol. 1988;102(3):227-30. [Crossref]  [PubMed] 
  36. Cathcart R, Wilson JA. Lump in the throat. Clin Otolaryngol. 2007;32(2):108-10. [Crossref]  [PubMed] 
  37. Mamede RC, De Mello-Filho FV, Dantas RO. Severe hypertrophy of the base of the tongue in adults. Otolaryngol Head Neck Surg. 2004;131(4):378-82. [Crossref]  [PubMed] 
  38. Agada FO, Coatesworth AP, Grace AR. Retroverted epiglottis presenting as a variant of globus pharyngeus. J Laryngol Otol. 2007;121(4):390-2. [Crossref]  [PubMed] 
  39. Quesada JL, Lorente J, Quesada P. Partial epiglottectomy as a possible treatment for globus pharyngeus? Eur Arch Otorhinolaryngol. 2000;257(7):386-8. [Crossref]  [PubMed] 
  40. Remacle M. The diagnosis and management of globus: a perspective from Belgium. Curr Opin Otolaryngol Head and Neck Surg. 2008;16(6):511-5. [Crossref]  [PubMed] 
  41. Burns P, Timon C. Thyroid pathology and the globus symptom: are they related? A two year prospective trial. J Laryngol Otol. 2007;121(3):242-5. [Crossref]  [PubMed] 
  42. Nam IC, Choi H, Kim ES, Mo EY, Park YH, Sun DI. Characteristics of thyroid nodules causing globus symptoms. Eur Arch Otorhinolaryngol. 2015;272(5):1181-8. [Crossref]  [PubMed] 
  43. Finkenbine R, Miele VJ. Globus hystericus: a brief review. Gen Hosp Psychiatry. 2004;26(1):78-82. [Crossref] 
  44. Deary IJ, Wilson JA, Kelly SW. Globus pharyngis, personality, and psychological distress in the general population. Psychosomatics. 1995;36(6):570-7. [Crossref] 
  45. Moser G, Wenzel-Abatzi TA, Stelzeneder M, Wenzel T, Weber U, Wiesnagrotzki S, et al. Globus sensation: pharyngoesophageal function, psychometric and psychiatric findings, and follow-up in 88 patients. Arch Intern Med. 1998;158(12):1365-73. [Crossref]  [PubMed] 
  46. Santé Omdl. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992. p.169-170.
  47. Wareing M, Elias A, Mitchell D. Management of globus sensation by the speech therapist. Logoped Phoniatr Vocol. 1997;22(1):39-42. [Crossref] 
  48. Rubin JS, Lieberman J, Harris TM. Laryngeal manipulation. Otolaryngol Clin North Am. 2000;33(5):1017-34. [Crossref] 
  49. Mathieson L. Vocal tract discomfort in hyperfunctional dysphonia. J Voice. 1993;2:40-8.
  50. Alaani A, Jassar P, Warfield AT, Gouldesbrough DR, Smith I. Heterotopic gastric mucosa in the cervical oesophagus (inlet patch) and globus pharyngeus-an under-recognised association. J Laryngol Otol. 2007;121(9):885-8. [Crossref]  [PubMed] 
  51. Lancaster JL, Gosh S, Sethi R, Tripathi S. Can heterotopic gastric mucosa present as globus pharyngeus? J Laryngol Otol. 2006;120(7):575-8. [Crossref]  [PubMed] 
  52. Husamaldin Z, Aung W, McFerran DJ. Smooth muscle tumour of the pharynx: a rare tumour presenting with globus pharyngeus symptoms. J Laryngol Otol. 2004;118(11):885-7. [Crossref]  [PubMed] 
  53. Reichel OA, Mayr D, Issing WJ. Oropharyngeal metastasis of a Merkel cell carcinoma of the skin. Eur Arch Otorhinolaryngol. 2003;260(5):258-60. [Crossref]  [PubMed] 
  54. Maran A, Jacobson I. Cervical osteophytes presenting with pharyngeal symptoms. Laryngoscope. 1971;81(3):412-7. [Crossref]  [PubMed] 
  55. Jabarkheel R, Chen YR, Xu L, Yan CH, Patel ZM, Desai AM. Transoral endoscopic resection of high cervical osteophytes with long-term symptom resolution: case series, imaging, and literature review. World Neurosurg. 2018;120:240-3. [Crossref]  [PubMed] 
  56. Kirveskari P, Puhakka H. Effect of occlusal adjustment on globus symptom. J Prosthet Dent. 1985;54(6):832-5. [Crossref] 
  57. Nachiappan S, Howlett DC. Mild dysphagia and globus sensation in an older man. BMJ. 2017;357. [Crossref]  [PubMed] 
  58. Beder E, Ozgursoy OB, Karatayli Ozgursoy S, Anadolu Y. Three-dimensional computed tomography and surgical treatment for Eagle's syndrome. Ear Nose Throat J. 2006;85(7):443-5. [Crossref] 
  59. Shiomi Y, Shiomi Y, Oda N, Hosoda S. Hyperviscoelasticity of epipharyngeal mucus may induce globus pharyngis. Ann Otol Rhinol Laryngol. 2002;111(12):1116-9. [Crossref]  [PubMed] 
  60. Haft S, Carey RM, Farquhar D, Mirza N. Anticholinergic medication use is associated with globus pharyngeus. J Laryngol Otol. 2016;130(12):1125-9. [Crossref]  [PubMed] 
  61. Luyten A, Bruneel L, Meerschman I, D'haeseleer E, Behlau M, Coffé C, et al. Prevalence of vocal tract discomfort in the Flemish population without self-perceived voice disorders. J Voice. 2016;30(3):308-14. [Crossref]  [PubMed] 
  62. Järvenpää P, Laatikainen A, Roine RP, Sintonen H, Arkkila P, Aaltonen LM. Symptom relief and health-related quality of life in globus patients: a prospective study. Logoped Phoniatr Vocol. 2019;44(2):67-72. [Crossref]  [PubMed] 
  63. Webb CJ, Makura ZG, Fenton JE, Jackson SR, McCormick MS, Jones AS. Globus pharyngeus: a postal questionnaire survey of UK ENT consultants. Clin Otolaryngol Allied Sci. 2000;25(6):566-9. [Crossref]  [PubMed] 
  64. Järvenpää P, Arkkila P, Aaltonen LM. Globus pharyngeus: a review of etiology, diagnostics, and treatment. Eur Arch Otorhinolaryngol. 2018;275(8):1945-53. [Crossref]  [PubMed] 
  65. Takwoingi YM, Kale US, Morgan DW. Rigid endoscopy in globus pharyngeus: how valuable is it? J Laryngol Otol. 2006;120(1):42-6. [Crossref]  [PubMed] 
  66. Amin MR, Postma GN, Setzen M, Koufman JA. Transnasal esophagoscopy: a position statement from the American Bronchoesophagological Association (ABEA). Otolaryngol Head Neck Surg. 2008;138(4):411-4. [Crossref]  [PubMed] 
  67. Postma GN, Cohen JT, Belafsky PC, Halum SL, Gupta SK, Bach KK, et al. Transnasal esophagoscopy: revisited (over 700 consecutive cases). Laryngoscope. 2005;115(2):321-3. [Crossref]  [PubMed] 
  68. Karahatay S, Ayan A, Aydin U, Ince S, Emer O, Alagoz E. The increased risk of globus pharyngeus in patients with chronic thyroiditis: a case control study. Eur Rev Med Pharmacol Sci. 2015;19(24):4722-7.
  69. Järvenpää P, Ilmarinen T, Geneid A, Pietarinen P, Kinnari TJ, Rihkanen H, et al. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. Eur Arch Otorhinolaryngol. 2017;274(2):931-7. [Crossref]  [PubMed] 
  70. Back GW, Leong P, Kumar R, Corbridge R. Value of barium swallow in investigation of globus pharyngeus. J Laryngol Otol. 2000;114(12):951-4. [Crossref]  [PubMed] 
  71. Caylakli F, Yavuz H, Erkan AN, Ozer C, Ozluoglu LN. Evaluation of patients with globus pharyngeus with barium swallow pharyngoesophagography. Laryngoscope. 2006;116(1):37-9. [Crossref]  [PubMed] 
  72. Ardran G. Feeling of a lump in the throat: thoughts of a radiologist. J R Soc Med. 1982;75(4):242-4.
  73. Luk WH, Lo AX, Au-Yeung AW, Lai MH, Woo YH, Wong LK, et al. The role of barium swallow pharyngoesophagography in the management of the globus pharyngeus: our ten years local experience of Asian population. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):153-5. [Crossref]  [PubMed]  [PMC] 
  74. Dworkin JP, Dowdall JR, Kubik M, Thottam PJ, Folbe A. The role of the modified barium swallow study and esophagram in patients with globus sensation. Dysphagia. 2015;30(5):506-10. [Crossref]  [PubMed] 
  75. Ortiz AS, Lawton A, Rives E, Gutierrez G, Dion GR. Correlating videofluoroscopic swallow study findings with subjective globus location. Laryngoscope. 2019;129(2):335-8. [Crossref]  [PubMed] 
  76. Lee BE, Kim GH. Globus pharyngeus: a review of its etiology, diagnosis and treatment. World J Gastroenterol. 2012;18(20):2462-71. [Crossref]  [PubMed]  [PMC] 
  77. Kahrilas PJ, Clouse RE, Hogan WJ. American Gastroenterological Association technical review on the clinical use of esophageal manometry. Gastroenterology. 1994;107(6):1865-84. [Crossref] 
  78. Ding H, Duan Z, Yang D, Zhang Z, Wang L, Sun X, et al. High-resolution manometry in patients with and without globus pharyngeus and/or symptoms of laryngopharyngeal reflux. BMC Gastroenterol. 2017;17(1):109. [Crossref]  [PubMed]  [PMC] 
  79. Tang Y, Huang J, Zhu Y, Qian A, Xu B, Yao W. Comparison of esophageal motility in gastroesophageal reflux disease with and without globus sensation. Rev Esp Enferm Dig. 2017;109(12):850-5. [Crossref]  [PubMed] 
  80. Batch AJ. Globus pharyngeus (Part I). J Laryngol Otol. 1988;102(2):152-8. [Crossref]  [PubMed] 
  81. Chen CL, Tsai CC, Chou AS, Chiou JH. Utility of ambulatory pH monitoring and videofluoroscopy for the evaluation of patients with globus pharyngeus. Dysphagia. 2007;22(1):16-9. [Crossref]  [PubMed] 
  82. Johnson LF, Demeester TR. Twenty-four-hour pH monitoring of the distal esophagus. Am J Gastroenterol. 1974;62(4):325-32.
  83. Sifrim D, Holloway R, Silny J, Tack J, Lerut A, Janssens J. Composition of the postprandial refluxate in patients with gastroesophageal reflux disease. Am J Gastroenterol. 2001;96(3):647-55. [Crossref]  [PubMed] 
  84. Sifrim D, Holloway R, Silny J, Xin Z, Tack J, Lerut A, et al. Acid, nonacid, and gas reflux in patients with gastroesophageal reflux disease during ambulatory 24-hour pH-impedance recordings. Gastroenterology. 2001;120(7):1588-98. [Crossref]  [PubMed] 
  85. Kroenke K. Efficacy of treatment for somatoform disorders: a review of randomized controlled trials. Psychosom Med. 2007;69(9):881-8. [Crossref]  [PubMed] 
  86. Khalil HS, Bridger MW, Hilton-Pierce M, Vincent J. The use of speech therapy in the treatment of globus pharyngeus patients. A randomised controlled trial. Rev Laryngol Otol Rhinol (Bord). 2003;124(3):187-90.
  87. Katz PO, Castell DO. Medical therapy of supraesophageal gastroesophageal reflux disease. Am J Med. 2000;108 Suppl 4a:170S-7S. [Crossref] 
  88. Park W, Hicks DM, Khandwala F, Richter JE, Abelson TI, Milstein C, et al. Laryngopharyngeal reflux: prospective cohort study evaluating optimal dose of proton‐pump inhibitor therapy and pretherapy predictors of response. Laryngoscope. 2005;115(7):1230-8. [Crossref]  [PubMed] 
  89. Bove MJ, Rosen C. Diagnosis and management of laryngopharyngeal reflux disease. Curr Opin Otolaryngol Head Neck Surg. 2006;14(3):116-23. [Crossref] 
  90. Divi V, Benninger MS. Diagnosis and management of laryngopharyngeal reflux disease. Curr Opin Otolaryngol Head Neck Surg. 2006;14(3):124-7. [Crossref]  [PubMed] 
  91. Othmer E, DeSouza C. A screening test for somatization disorder (hysteria). Am J Psychiatry. 1985;142(10):1146-9. [Crossref]  [PubMed] 
  92. Speckens AE, van Hemert AM, Spinhoven P, Hawton KE, Bolk JH, Rooijmans HG. Cognitive behavioural therapy for medically unexplained physical symptoms: a randomised controlled trial. BMJ. 1995;311(7016):1328-32. [Crossref]  [PubMed]  [PMC] 
  93. Brown SR, Schwartz JM, Summergrad P, Jenike MA. Globus hystericus syndrome responsive to antidepressants. Am J Psychiatry. 1986;143(7):917-8. [Crossref]  [PubMed] 
  94. Cybulska EM. Globus hystericus--a somatic symptom of depression? The role of electroconvulsive therapy and antidepressants. Psychosom Med. 1997;59(1):67-9. [Crossref]  [PubMed] 
  95. Kiebles JL, Kwiatek MA, Pandolfino JE, Kahrilas PJ, Keefer L. Do patients with globus sensation respond to hypnotically assisted relaxation therapy? A case series report. Dis Esophagus. 2010;23(7):545-53. [Crossref]  [PubMed] 
  96. Millichap F, Lee M, Pring T. A lump in the throat: should speech and language therapists treat globus pharyngeus? Disabil Rehabil. 2005;27(3):124-30. [Crossref]  [PubMed] 
  97. Bajbouj M, Becker V, Eckel F, Miehlke S, Pech O, Prinz C, et al. Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology. 2009;137(2):440-4. [Crossref]  [PubMed] 
  98. Meining A, Bajbouj M, Preeg M, Reichenberger J, Kassem A, Huber W, et al. Argon plasma ablation of gastric inlet patches in the cervical esophagus may alleviate globus sensation: a pilot trial. Endoscopy. 2006;38(06):566-70. [Crossref]  [PubMed] 
  99. Kristo I, Rieder E, Paireder M, Schwameis K, Jomrich G, Dolak W, et al. Radiofrequency ablation in patients with large cervical heterotopic gastric mucosa and globus sensation: closing the treatment gap. Dig Endosc. 2018;30(2):212-8. [Crossref]  [PubMed]