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Review
. 2024 Oct 15;8(4):e70014.
doi: 10.1002/oto2.70014. eCollection 2024 Oct-Dec.

Diagnosis and Management of Retrograde Cricopharyngeal Dysfunction: A Systematic Review

Raj Malhotra  1 , Hamza Khan  1 , Sydney Zaransky  2 , Joseph Celidonio  1 , Kenneth Yan  2 , Rachel Kaye  2
Affiliations
Review

Diagnosis and Management of Retrograde Cricopharyngeal Dysfunction: A Systematic Review

Raj Malhotra et al. OTO Open. .

Abstract

Objective: Retrograde cricopharyngeal dysfunction (R-CPD) is a syndrome with rapidly increasing awareness since being first described in March 2019. As such, few cases of R-CPD are currently reported in the literature. The goal of this study is to provide a comprehensive systematic review of the available literature on R-CPD, including patient characteristics, diagnosis, and management.

Data sources: PubMed, Scopus, EMBASE.

Review methods: A systematic review of the available English literature was conducted using the data sources PubMed, Scopus, and EMBASE. Studies with original data of patients experiencing classic symptoms of R-CPD were included. Independent abstract screening followed by full-text screening was performed to assess study eligibility. Data extraction of patient demographics, symptoms, treatment, and follow-up were subsequently performed.

Results: Common presentations of R-CPD include abelchia (100%), abdominal bloating (83%), and gurgling noises (75%). 554 (86.9%) patients had improved symptoms after initial treatment with BTX. The most common initial dose was 50 units in 204 (37.3%) patients. Subsequent BTX injections resolved symptoms in 40 (80%) patients. Six patients ultimately received CP myotomy for recurrent symptoms, resulting in long-term resolution in 4 (67%) patients.

Conclusion: R-CPD is a newly recognized syndrome with effective treatment options including botulinum toxin injections and cricopharyngeal myotomy, where appropriate. Diagnostic modalities including esophageal manometry may aid in the initial work up of R-CPD, however further studies are required to assess its diagnostic utility.

Keywords: abelchia; botulinum toxin; cricopharyngeal myotomy; retrograde cricopharyngeal dysfunction.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
PRISMA flow diagram demonstrating the selection process for articles included in the systematic review.
Figure 2
Figure 2
Initial botulinum toxin dose (units) injected into the cricopharyngeal muscle.
Figure 3
Figure 3
Symptom management following botulinum toxin (BTX) injection. BTX, botulinum toxin; CP, cricopharyngeal.
See this image and copyright information in PMC

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