Prospective Controlled Study of Endoscopic Botulinum Toxin Injection for Retrograde Cricopharyngeus Dysfunction: The...

Area of Science:

• Gastroenterology
• Otolaryngology
• Physiology

Background:

• Retrograde cricopharyngeus dysfunction (R-CPD) is characterized by an inability to belch, leading to chronic gastrointestinal distress.
• Current diagnostic methods for R-CPD require validation, and effective treatment options are limited.

Purpose of the Study:

• To validate high-resolution manometry (HRM) diagnostic criteria for R-CPD.
• To assess the feasibility and efficacy of cricopharyngeal botulinum toxin injection (CBTI) for treating R-CPD.

Main Methods:

• Patients with manometrically diagnosed R-CPD and asymptomatic volunteers were enrolled.
• HRM with carbonated drink provocation was used for diagnosis.
• The R-CPD treatment group received CBTI, while a control group received no treatment or delayed treatment.

Main Results:

• HRM revealed characteristic esophageal pressurization and upper esophageal sphincter dysfunction in R-CPD patients, absent in controls.
• 92% of patients receiving CBTI achieved the ability to belch, with significant symptom and quality of life improvement.
• 84% of the treatment group reported satisfaction with the CBTI outcome at 3 months.

Conclusions:

• HRM with carbonated drink provocation provides pathognomonic diagnostic signs for R-CPD.
• Flexible endoscopic CBTI is a highly effective treatment for symptomatic relief in R-CPD patients compared to no intervention.