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Related Experiment Video

Updated: Jan 14, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
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Low Dose Botulinum Toxin Injection in Retrograde Cricopharyngeal Dysfunction.

Jaouad Abari1, Mayuka Kameshima1, Magali Surmont2

  • 1Department of Otorhinolaryngology Head and Neck Surgery.

The Journal of Craniofacial Surgery
|January 13, 2026
PubMed
Summary
This summary is machine-generated.

Retrograde cricopharyngeal dysfunction (R-CPD) causes inability to belch. Low-dose botulinum toxin injections offer symptomatic improvement for R-CPD, though some patients may need revision surgery.

Keywords:
Botulinum toxinR-CPDcase-seriesretrograde cricopharyngeal dysfunctionspeech-language therapy

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Area of Science:

  • Otolaryngology
  • Gastroenterology
  • Neurology

Background:

  • Retrograde cricopharyngeal dysfunction (R-CPD) presents with symptoms like inability to belch.
  • Standard examinations often show no abnormalities in R-CPD patients.
  • Botulinum toxin injection is a common treatment for R-CPD.

Purpose of the Study:

  • To evaluate the effectiveness of low-dose botulinum toxin injections for R-CPD.
  • To assess outcomes in patients with inability to belch treated with botulinum toxin.

Main Methods:

  • Retrospective case series of 3 consecutive R-CPD patients.
  • Botulinum toxin injected into the cricopharyngeal muscle at doses of 12.5-17.5 units.
  • Clinical swallowing evaluations performed by speech-language pathologists.

Main Results:

  • All 3 patients experienced symptomatic improvement after low-dose botulinum toxin injection.
  • Two patients required revision surgery for sustained improvement.
  • No intraoperative or postoperative complications were reported.
  • Swallowing evaluations revealed neck muscle hypertonia and weak tongue strength in 2 patients.

Conclusions:

  • Low-dose botulinum toxin injection is an effective, albeit unpredictable, treatment for R-CPD.
  • While symptom improvement occurred in all cases, some patients needed further intervention.
  • The findings highlight the potential of targeted botulinum toxin therapy for R-CPD.