We describe a series of four patients who presented with ‘high globus pharyngeus’, who all had an abnormally curled epiglottis tip touching and indenting the tongue base. The actual incidence of ‘curling epiglottis’, as well as the potential impact of this variation in persistent globus symptoms, is not known. We therefore describe for the first time a series of patients with this anatomical variant of the epiglottis, each of whom experienced unresolved globus symptoms despite receiving intensive medical treatment. In the literature, the success rate for improvement in symptoms following medical treatment ranges from 68 to 80 per cent.
Following CO2 laser partial epiglottectomy, all four patients experienced complete relief of their symptoms.
We advocate consideration of this treatment for high globus pharyngeus that fails to respond to conservative treatment, in cases with proven curled epiglottis on endoscopic examination.