Retrograde Cricopharyngeal Dysfunction: Patient Characteristics and Outcomes in Australia

Area of Science:

• Otolaryngology
• Gastroenterology
• Neurology

Background:

• Retrograde cricopharyngeal dysfunction (RCPD) is a condition characterized by the inability to belch.
• Current first-line treatment for RCPD involves Botulinum A toxin (BonT-A) injections into the cricopharyngeus muscle.
• Understanding treatment outcomes and patient factors is crucial for optimizing RCPD management.

Purpose of the Study:

• To evaluate the efficacy of Botulinum A toxin (BonT-A) injections in treating retrograde cricopharyngeal dysfunction (RCPD).
• To identify patient demographics and treatment parameters associated with successful RCPD outcomes.
• To assess symptom resolution rates at short-term and long-term follow-up.

Main Methods:

• Retrospective chart review of 109 patients diagnosed with RCPD between January 2018 and November 2024.
• Data collection included demographics, clinical information, and symptom scores using the RCPD-Q questionnaire (from late 2021).
• Analysis of treatment outcomes following initial BonT-A injection, with follow-up at 4 weeks and >3 months.

Main Results:

• Of 109 patients, 56.9% were female, with a mean age of 30.0 years.
• Initial treatment in 74 patients showed complete symptom resolution in 71.6% at 4 weeks.
• At >3 months follow-up, 56.7% of 30 patients reported complete resolution, while 33.3% experienced no resolution or symptom reversion.

Conclusions:

• Botulinum A toxin (BonT-A) injections demonstrate significant efficacy in managing retrograde cricopharyngeal dysfunction (RCPD).
• Factors positively associated with successful treatment outcomes include younger patient age, administration under general anesthesia, and higher BonT-A doses.
• While short-term resolution is high, long-term symptom persistence or recurrence warrants further investigation and management strategies.