Unilateral EMG-Guided Botulinum Toxin for Retrograde Cricopharyngeus Dysfunction: A Prospective Clinical and...

Area of Science:

• Gastroenterology
• Otolaryngology
• Neurology

Background:

• Retrograde cricopharyngeus dysfunction (R-CPD) is a condition causing inability to burp, leading to bloating and flatulence.
• Percutaneous botulinum neurotoxin (BoNT) injection is a potential treatment, but evidence is limited.

Purpose of the Study:

• To evaluate the clinical effects of varying doses of EMG-guided unilateral BoNT injections in R-CPD patients.
• To assess symptom severity, quality of life, and the role of EMG parameters.

Main Methods:

• A prospective, open-label study involving 67 R-CPD patients.
• EMG-guided unilateral BoNT injections with doses ranging from 10 to 30 U.
• Assessment of symptoms and quality of life at baseline, 1 month, and 4 months post-treatment.

Main Results:

• 55.2% of patients responded to treatment at 1 month, with higher doses showing better response rates (64.4%), especially in females.
• Significant improvements in symptom severity and quality of life were observed at 1 month and sustained at 4 months.
• Higher cricopharyngeus EMG activity correlated with more severe symptoms and poorer treatment response.

Conclusions:

• Unilateral EMG-guided BoNT injection is a safe and effective treatment for R-CPD.
• Electromyography may play a role in understanding R-CPD pathophysiology and guiding treatment decisions.