The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction
Objectives To report the percentage of patients with symptom relief 6 or more months after botulinum toxin injection into the cricopharyngeus muscle for retrograde cricopharyngeus dysfunction (R-CPD). Study Design Retrospective case series of consecutively treated patients. Setting Tertiary care lar...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | OTO Open |
| Online Access: | https://doi.org/10.1177/2473974X20938342 |
| _version_ | 1797423005423370240 |
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| author | Rebecca C. Hoesli MD Melissa L. Wingo PA-C Robert W. Bastian MD |
| author_facet | Rebecca C. Hoesli MD Melissa L. Wingo PA-C Robert W. Bastian MD |
| author_sort | Rebecca C. Hoesli MD |
| collection | DOAJ |
| description | Objectives To report the percentage of patients with symptom relief 6 or more months after botulinum toxin injection into the cricopharyngeus muscle for retrograde cricopharyngeus dysfunction (R-CPD). Study Design Retrospective case series of consecutively treated patients. Setting Tertiary care laryngology clinic. Subjects and Methods A review was performed of the first 200 patients who were diagnosed with R-CPD and treated with botulinum toxin injection into the cricopharyngeus muscle by a single surgeon. The study group was limited to those for whom a minimum of 6 months has elapsed since the injection. Items assessed were efficacy, safety, complications, and duration of benefit. Results Of 200 patients treated, (99.5%) gained the ability to burp and 95% experienced relief of the cardinal symptoms of R-CPD: inability to belch, socially awkward gurgling noises, abdominal/chest pressure and bloating, and excessive flatulence. For those who experienced relief, 159 (79.9%) maintained a satisfactory ability to burp after 6 months. Of those who did not maintain the ability, 12 underwent a second injection, 1 patient underwent 3 subsequent injections, and 3 patients underwent partial myotomy. No patients experienced complications of botulinum toxin injection itself, and 4 patients had complications from esophagoscopy or anesthesia. Conclusion In a case series of 200 patients with retrograde cricopharyngeus dysfunction, 99% experienced relief of the cardinal symptoms and 79.9% experienced lasting relief of their symptoms beyond pharmacologic duration of action after a single injection of botulinum toxin into the cricopharyngeus muscle. Relief can be reestablished in the remainder via additional injection or cricopharyngeus myotomy. |
| first_indexed | 2024-03-09T07:40:15Z |
| format | Article |
| id | doaj.art-5c27064900504014ae02b2f21edab999 |
| institution | Directory Open Access Journal |
| issn | 2473-974X |
| language | English |
| last_indexed | 2024-03-09T07:40:15Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj.art-5c27064900504014ae02b2f21edab9992023-12-03T04:49:40ZengWileyOTO Open2473-974X2020-06-01410.1177/2473974X20938342The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus DysfunctionRebecca C. Hoesli MD0Melissa L. Wingo PA-C1Robert W. Bastian MD2Bastian Voice Institute, Downers Grove, Illinois, USABastian Voice Institute, Downers Grove, Illinois, USABastian Voice Institute, Downers Grove, Illinois, USAObjectives To report the percentage of patients with symptom relief 6 or more months after botulinum toxin injection into the cricopharyngeus muscle for retrograde cricopharyngeus dysfunction (R-CPD). Study Design Retrospective case series of consecutively treated patients. Setting Tertiary care laryngology clinic. Subjects and Methods A review was performed of the first 200 patients who were diagnosed with R-CPD and treated with botulinum toxin injection into the cricopharyngeus muscle by a single surgeon. The study group was limited to those for whom a minimum of 6 months has elapsed since the injection. Items assessed were efficacy, safety, complications, and duration of benefit. Results Of 200 patients treated, (99.5%) gained the ability to burp and 95% experienced relief of the cardinal symptoms of R-CPD: inability to belch, socially awkward gurgling noises, abdominal/chest pressure and bloating, and excessive flatulence. For those who experienced relief, 159 (79.9%) maintained a satisfactory ability to burp after 6 months. Of those who did not maintain the ability, 12 underwent a second injection, 1 patient underwent 3 subsequent injections, and 3 patients underwent partial myotomy. No patients experienced complications of botulinum toxin injection itself, and 4 patients had complications from esophagoscopy or anesthesia. Conclusion In a case series of 200 patients with retrograde cricopharyngeus dysfunction, 99% experienced relief of the cardinal symptoms and 79.9% experienced lasting relief of their symptoms beyond pharmacologic duration of action after a single injection of botulinum toxin into the cricopharyngeus muscle. Relief can be reestablished in the remainder via additional injection or cricopharyngeus myotomy.https://doi.org/10.1177/2473974X20938342 |
| spellingShingle | Rebecca C. Hoesli MD Melissa L. Wingo PA-C Robert W. Bastian MD The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction OTO Open |
| title | The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction |
| title_full | The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction |
| title_fullStr | The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction |
| title_full_unstemmed | The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction |
| title_short | The Long-term Efficacy of Botulinum Toxin Injection to Treat Retrograde Cricopharyngeus Dysfunction |
| title_sort | long term efficacy of botulinum toxin injection to treat retrograde cricopharyngeus dysfunction |
| url | https://doi.org/10.1177/2473974X20938342 |
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