Radiologic evaluation of the globus symptom using videotape recorder

The authors examined barium swallow in 213 patients with globus symptom and 79 patients with vague gastric problems without globus symptom. Abnormal findings were more frequently detected on videorecording than on conventional esophagogram. Radiologic findings were transient cricopharyngeal indentation (CPI), residual barium collection and delayed clearing from hypopharynx (RB), laryngeal penetration of barium, barium retention in vallecula and or pyriform sinuses. Among them residual barium in hypopharynx was more frequently detected in patients with globus symptom than in patients without globus symptom. Globus symptom was more frequent in adult women, but age and sex difference did not affect the incidence of the abnormal radiologic findings. Cricopharyngeal indentation was most frequently seen at the level of C5-6 interspace and had a tendency of moving upward gradually during the indentation in about half of the cases. Most of the CPI was seen in early phase of swallowing and was visible within 1 sec. Residual barium collection was mostly seen in C6 or C6-7 level. RB had no cause and effect relationship with CPI, and it was not secondary result of obstructive effect of CPI. The authors think that videotape recording can be a useful method for evaluation of globus symptom. The residual barium collection in hypopharynx can be a significant finding in globus symptom