Characteristics of thyroid nodules causing globus symptoms

Eur Arch Otorhinolaryngol. 2015 May;272(5):1181-8. doi: 10.1007/s00405-015-3525-9. Epub 2015 Jan 31.

Abstract

A globus sensation is one of the most common complaints in otolaryngologic clinics, and laryngopharyngeal reflux is the most common cause. However, thyroid nodules also can cause globus symptoms. The purpose of this study was to identify the characteristics of thyroid nodules that cause globus. We selected patients prospectively with a single thyroid nodule on ultrasonograms. Patients with other causes of globus symptoms were excluded using questionnaires, fiber optic laryngoscopic examinations, and a psychiatric screening tool. In total, 175 patients were enrolled. Patients were divided into two groups according to globus symptoms. Ultrasonographic characteristics and clinicopathological parameters were compared between the groups. Among various clinicopathologic and ultrasonographic parameters, size and horizontal location of the thyroid nodule showed significant differences between the groups. Nodules larger than 3 cm and those located anterior to the trachea had a tendency to cause globus symptoms. Regarding horizontal location, nodules that all parts were located anterior to the trachea showed a higher tendency to cause globus symptoms than nodules that only some parts were located anterior to the trachea. In conclusion, thyroid nodules with specific size and location can cause globus symptoms, and this finding can be indicated in patient counseling. Also, conservative treatments or thyroidectomy may be helpful in relieving patients' globus symptoms.

MeSH terms

  • Adult
  • Aged
  • Conversion Disorder* / diagnosis
  • Conversion Disorder* / etiology
  • Conversion Disorder* / physiopathology
  • Diagnosis, Differential
  • Disease Management
  • Female
  • Humans
  • Laryngopharyngeal Reflux / diagnosis*
  • Laryngoscopy / methods
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Organ Size
  • Surveys and Questionnaires
  • Symptom Assessment / methods
  • Thyroid Gland* / diagnostic imaging
  • Thyroid Gland* / surgery
  • Thyroid Nodule* / diagnosis
  • Thyroid Nodule* / diagnostic imaging
  • Thyroid Nodule* / physiopathology
  • Thyroid Nodule* / therapy
  • Thyroidectomy / methods
  • Ultrasonography