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Cervical Inlet Patches in R-CPD: An Unrecognized Predictor of Treatment Failure
Andrew Geoffrey Tritter1, Nabeeha Hasan2, Jered Wilson2
1Department of Otorhinolaryngology - Head & Neck Surgery, UTHealth Houston, McGovern Medical School, Houston, Texas, USA.
The Laryngoscope
|August 11, 2026
Summary
Cervical esophageal inlet patches (CIP) are common in patients with Retrograde cricopharyngeus dysfunction (R-CPD). The presence of CIP and increasing age predict a higher likelihood of long-term treatment failure for R-CPD.
Area of Science:
- Gastroenterology
- Otolaryngology
- Esophageal Disorders
Background:
- Retrograde cricopharyngeus dysfunction (R-CPD) lacks extensive data on endoscopic findings and predictors of treatment success.
- Cervical esophageal inlet patches (CIP) are a previously underreported endoscopic finding in R-CPD patients.
Purpose of the Study:
- To determine the prevalence of CIP in R-CPD patients undergoing treatment.
- To evaluate the association between CIP and treatment outcomes for R-CPD.
- To identify factors predicting treatment response in R-CPD.
Main Methods:
- Retrospective cohort review of 101 patients treated with cricopharyngeal botulinum toxin injection (CPBTI) for R-CPD.
- Analysis of demographics, endoscopic findings (including CIP), and treatment responses at 6 weeks and ≥6 months.
- Univariate and multivariate analyses to assess associations between findings and treatment outcomes.
Main Results:
- 19.8% of R-CPD patients had one or more CIP.
- CIP and increasing age were significant predictors of failure to sustain long-term treatment response after CPBTI.
- CIP presence was associated with a 5.14-fold increased odds of long-term treatment failure (p=0.006).
Conclusions:
- CIP is highly prevalent in R-CPD patients.
- CIP, along with increasing age, significantly increases the risk of long-term treatment failure following CPBTI for R-CPD.
- Endoscopic identification of CIP may aid in predicting treatment outcomes for R-CPD.