In-Office Injection for Retrograde Cricopharyngeal Dysfunction Treatment

This "How I Do It" article details an in-office, EMG-guided modified lateral transcervical botulinum toxin injection into the cricopharyngeus muscle for retrograde cricopharyngeal dysfunction. It highlights patient positioning, surface landmarking, and EMG confirmation of correct needle placement using swallow and sniff maneuvers. The technique provides a rapid office-based alternative to the operating room approach and includes practical counseling on expected side effects and the common need for a planned contralateral injection when initial benefit is incomplete or wanes.