Can first cervical vertebrae misalignment be one of the possible etiology of globus pharyngeus?

Yaşaroğlu Ö. F., Arslan S. S., DEMİR N.

Medical Hypotheses, vol.183, 2024 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 183
  • Publication Date: 2024
  • Doi Number: 10.1016/j.mehy.2023.111255
  • Journal Name: Medical Hypotheses
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, Veterinary Science Database
  • Keywords: Dysphagia, Exercise therapy, Swallowing disorders, Videofluoroscopic swallowing study
  • Hacettepe University Affiliated: Yes


Globus pharyngeus (GP) is a problem characterised by the sensation of a foreign body in the throat. Although it was previously considered as a psychological problem, it has been associated with various etiological factors such as gastrointestinal problems and cervical pathologies. The etiology and treatment of globus pharyngeus is still controversial in the literature. The hyoid muscles are innervated by the trigeminus (V), facialis (VII) and ansa cervicalis (hypoglossus (XII) and cervical spinal nerves (C1-2 nerves)). We hypothesized that C1 vertebra misalignment may cause cervical spinal nerve impingement and affect the hyoid muscles via the ansa cervicalis or the trigeminal convergence pathway in the descending pathways and cause GP. In the present case report, C1 vertebra misalignment was observed in the radiographic evaluations of a 26-year-old male patient who was admitted with the diagnosis of GB. After 5 weeks (once a week/30 min) of cervical manual physical therapy by a physiotherapist, the C1 misalignment improved, and all complaints were resolved. Based on our hypothesis, cervical misalignment should be considered as an etiological factor in patients with GP. Accordingly, cervical manual physical therapy approaches may be effective in the treatment of GP.