Health-Related Quality of Life Following Botulinum Toxin for Retrograde Cricopharyngeus Dysfunction

Retrograde cricopharyngeus dysfunction (R-CPD) is a form of cricopharyngeal achalasia in which the inability to burp leads to gaseous esophageal distension, abdominal bloating, throat gurgling, and excessive flatulence. Botulinum toxin (BTX) injection of the cricopharyngeus (CP) muscle has emerged as an effective treatment, but the symptom burden of R-CPD and treatment effects on health-related quality of life (HRQoL) remain incompletely characterized.

In this prospective cohort study, patients undergoing CP BTX treatment for R-CPD were enrolled. Participants received an initial CP injection of 75-100 units of onabotulinumtoxinA under general anesthesia; some underwent a second injection for incomplete response. HRQoL was assessed using the Short Form-36 (SF-36) survey at baseline and 6 months after treatment. Demographic and clinical data were collected, and Welch t-tests and subgroup analyses were performed.

Pre- and post-treatment SF-36 data were available for 25 participants. Significant improvements were observed in 6 of 8 SF-36 domains: role limitations due to physical health, bodily pain, general health, social functioning, role limitations due to emotional problems, and emotional well-being. Both Physical and Mental Component Summary Scores improved significantly after treatment. Subgroup analyses identified numerical differences by sex and psychiatric history, but none remained statistically significant after correction for multiple comparisons.

BTX treatment for R-CPD was associated with improvement in HRQoL. These findings support recognition of R-CPD and overall understanding of its burden on patients. Limitations include small sample size and selection bias, underscoring the need for larger longitudinal studies to confirm these findings and assess long-term outcomes.