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Operating Room or In-Office Injection for Retrograde Cricopharyngeal Dysfunction Botulinum Toxin Injection.

Salwa AlRashed AlHumaid1, Jennifer A Silver2, Karen M Kost1

  • 1Otolaryngology, Montreal General Hospital, McGill University, Montreal, Canada.

The Laryngoscope
|April 14, 2025
PubMed
Summary
This summary is machine-generated.

Botulinum toxin injections effectively treat Retrograde Cricopharyngeal Dysfunction (RCPD), or "No Burp Syndrome," in both in-office and operating room settings. The best approach depends on individual patient needs and preferences.

Keywords:
clinical practice guidelines laryngologylaryngologyquality of lifeupper esophageal sphincter laryngology

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Area of Science:

  • Gastroenterology
  • Otolaryngology
  • Minimally Invasive Procedures

Background:

  • Retrograde Cricopharyngeal Dysfunction (RCPD), or "No Burp Syndrome," is a rare condition causing significant discomfort due to cricopharyngeus muscle dysfunction.
  • Symptoms include bloating, chest and abdominal pain, gurgling, and flatulence, impacting patient quality of life.

Purpose of the Study:

  • To compare the effectiveness and safety of botulinum toxin injections for RCPD treatment.
  • The study evaluated outcomes when procedures were performed in-office versus in an operating room setting.

Main Methods:

  • A clinical review of RCPD patients undergoing botulinum toxin injection into the cricopharyngeus muscle.
  • Procedures were conducted either in-office or under general anesthesia in the operating room.
  • Success rates, complications, and patient tolerance were analyzed and compared.

Main Results:

  • Botulinum toxin injections demonstrated similar efficacy in both in-office and operating room settings for relieving RCPD symptoms.
  • In-office procedures offered greater convenience and faster recovery.
  • Operating room procedures provided enhanced control under general anesthesia, with slightly different side effect profiles, such as transient throat discomfort in in-office cases.

Conclusions:

  • Both in-office and operating room botulinum toxin injections are viable and effective treatments for RCPD.
  • The optimal procedural setting should be individualized based on patient factors, including preferences, comorbidities, and available resources.