AIM: Globus pharyngeus is not an uncommon symptom.Presently, its unclear dated pathophysiology remains unclearand the disease can not be evaluated correctly with routinediagnostic methods. The objective of this study ...AIM: Globus pharyngeus is not an uncommon symptom.Presently, its unclear dated pathophysiology remains unclearand the disease can not be evaluated correctly with routinediagnostic methods. The objective of this study is to establishthe normal values of pharyngeal and UES pressure,pharyngeal transit time in healthy volunteers and to comparethe differences betweer healthy volunteers and patients withglobus pharyngeus.METHODS: Twenty-four healthy volunteers and thirty-twopatients clinically diagnosed as globus pharyngeus enteredthe study. Pressures of pharynx and UES were measured.Pharyngeal transit time was measured by videofluoroscopicprocedure.RESULTS: Normal pressure of pharynx, and normal restingpressure of UES were 157.81±63.86 mmHg and 68.33±37.56 mmHg, respectively. The corresponding values inthe patients were 175.50±93.47 mmHg and 71.38±41.42mmHg. The pharyngeal transit time was 1.44±0.30 s innormal control group, among them there were 4 caseswith stasis of barium in the valleculae and one in the piriformsinus. 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 ofbarium in the valleculae and 5 in the piriform sinus. 9 caseshad laryngeal penetration and 2 had aspiration. There wereno statistical differences of pressures of pharynx, UES andthe pharyngeal transit time between the two groups. Butthere was an association between laryngeal penetrationand globus pharyngeus.CONCLUSION: Radiographic examination of the pharynxshow specific findings of pharyngeal dysfunction in patientswith globus pharyngeus. UES pressure is normal in mostpatients. Hence, we find no role for UES hypertonicity as anetiologic factor in globus pharyngeus.展开更多
AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to ...AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to predict the DeMeester score has not been adequately explored. METHODS:627 patients in the referral database received esophageal manometry and ambulatory 24-hour pH monitoring.Study data included LES resting pressure(LESP), overall LES length(OL)and abdominal length(AL),total vector volume(TVV)and intrabdominal vector volume(IVV). RESULTS:In cases where LESP,TVV or IVV were all below normal,there was an 81.4%probability of a positive DeMeester score.In cases where all three were normal, there was an 86.9%probability that the DeMeester score would be negative.Receiver-operating characteristics(ROC) for LESP,TVV and IVV were nearly identical and indicated no useful cut-off values.Logistic regression demonstrated that LESP and IVV had the strongest association with a positive DeMeester score;however,the regression formula was only 76.1%accurate. CONCLUSION:While the indices based on TVV,IVV and LESP are more sensitive and specific,respectively,than any single measurement,the measurement of vector volumes does not add significantly to the diagnosis of GERD.展开更多
文摘AIM: Globus pharyngeus is not an uncommon symptom.Presently, its unclear dated pathophysiology remains unclearand the disease can not be evaluated correctly with routinediagnostic methods. The objective of this study is to establishthe normal values of pharyngeal and UES pressure,pharyngeal transit time in healthy volunteers and to comparethe differences betweer healthy volunteers and patients withglobus pharyngeus.METHODS: Twenty-four healthy volunteers and thirty-twopatients clinically diagnosed as globus pharyngeus enteredthe study. Pressures of pharynx and UES were measured.Pharyngeal transit time was measured by videofluoroscopicprocedure.RESULTS: Normal pressure of pharynx, and normal restingpressure of UES were 157.81±63.86 mmHg and 68.33±37.56 mmHg, respectively. The corresponding values inthe patients were 175.50±93.47 mmHg and 71.38±41.42mmHg. The pharyngeal transit time was 1.44±0.30 s innormal control group, among them there were 4 caseswith stasis of barium in the valleculae and one in the piriformsinus. 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 ofbarium in the valleculae and 5 in the piriform sinus. 9 caseshad laryngeal penetration and 2 had aspiration. There wereno statistical differences of pressures of pharynx, UES andthe pharyngeal transit time between the two groups. Butthere was an association between laryngeal penetrationand globus pharyngeus.CONCLUSION: Radiographic examination of the pharynxshow specific findings of pharyngeal dysfunction in patientswith globus pharyngeus. UES pressure is normal in mostpatients. Hence, we find no role for UES hypertonicity as anetiologic factor in globus pharyngeus.
文摘AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to predict the DeMeester score has not been adequately explored. METHODS:627 patients in the referral database received esophageal manometry and ambulatory 24-hour pH monitoring.Study data included LES resting pressure(LESP), overall LES length(OL)and abdominal length(AL),total vector volume(TVV)and intrabdominal vector volume(IVV). RESULTS:In cases where LESP,TVV or IVV were all below normal,there was an 81.4%probability of a positive DeMeester score.In cases where all three were normal, there was an 86.9%probability that the DeMeester score would be negative.Receiver-operating characteristics(ROC) for LESP,TVV and IVV were nearly identical and indicated no useful cut-off values.Logistic regression demonstrated that LESP and IVV had the strongest association with a positive DeMeester score;however,the regression formula was only 76.1%accurate. CONCLUSION:While the indices based on TVV,IVV and LESP are more sensitive and specific,respectively,than any single measurement,the measurement of vector volumes does not add significantly to the diagnosis of GERD.
