Botulinum Toxin Effective for Retrograde Cricopharyngeal Dysfunction in Both Clinic and OR Settings: Study

A new study published in the journal of The Laryngoscope showed that both in-office and operating room botulinum toxin injections effectively treat retrograde cricopharyngeal dysfunction (R-CPD), with the choice depending on patient preference, comorbidities, and available resources, as each setting has its own benefits and risks.

The patients with retrograde cricopharyngeal dysfunction have difficulty burping and frequently experience chest pressure, bloating, and pain due to improper relaxation of the upper esophageal sphincter. Because it temporarily weakens the hyperactive muscle and improves gas release, botulinum toxin injection into the cricopharyngeus muscle has emerged as a crucial therapy. Both an operating room and an office environment can be used for this technique.

Deeper sedation and improved vision are provided by OR-based injections, which are beneficial for patients with complicated anatomy or anxiety. On the other hand, in-office injections are speedier, do not require general anesthesia, and are less expensive while still effectively relieving most people's symptoms. To assess the clinical results and adverse effect profiles of botulinum toxin injection for RCPD when carried out in an operating room vs an office, this study was carried out.

A clinical evaluation of RCPD patients was carried out, with an emphasis on diagnosis based on physical examination and history. The cricopharyngeus muscle was treated with botulinum toxin either in the operating room or in the office. In both operative settings, success rates, complications, and patient tolerance were examined and contrasted.

In all situations, botulinum toxin injections were successful in restoring burping capacity and reducing related discomfort. While operating room operations provided for more procedural control under general anesthesia, in-office procedures offered benefits in terms of convenience and recuperation time. There were small differences in the side effect profiles where in-office patients were more likely to report temporary throat soreness.

Overall, the findings of this study demonstrated that, most people with RCPD can be successfully treated by injecting botulinum toxin into the CP muscle. Both methods have comparable success percentages, however their adverse effect profiles change whether they are carried out in an office or an operating room.

Reference:

AlRashed AlHumaid, S., Silver, J. A., & Kost, K. M. (2025). Operating room or in-office injection for retrograde Cricopharyngeal Dysfunction botulinum toxin injection. The Laryngoscope, 135(10), 3467–3469. https://doi.org/10.1002/lary.32163