Retrograde Cricopharyngeal Dysfunction: Patient Characteristics and Outcomes in Australia

OBJECTIVE: Retrograde cricopharyngeal dysfunction (RCPD) is characterised by an inability to burp. Typical first-line management involves injection of Botulinum A toxin (BonT-A) into the cricopharyngeus. We present our series of 109 RCPD patients. METHODS: A retrospective chart review was conducted between January 2018 and November 2024. Demographics and clinical data were extracted. From late 2021 onwards, we also started collecting scores from a 7-point Likert questionnaire based on the six cardinal symptoms of RCPD (RCPD-Q in short). RESULTS: A109 patients were identified. Sixty-two (56.9%) were female. Mean age was 30.0 (range: 14-72). The majority (91.7%) were of Caucasian ethnicity. Eighty patients completed the RCPD-Q at their initial consultation, with a mean score of 27.6/36 (range: 13-36). Seventy-four patients underwent initial treatment. At first follow-up within 4 weeks, 53 patients (71.6%) had complete resolution, 11 (14.9%) had partial resolution and seven (9.5%) had no change in symptoms. In the 30 patients who completed follow-up at > 3 months after treatment, 17 patients (56.7%) reported complete resolution, three patients (10%) reported partial resolution and 10 patients (33.3%) reported no resolution or reversion to baseline symptoms. CONCLUSION: Younger age, treatment under general anaesthesia, and higher doses of BonT-A were associated with higher rates of success. LEVEL OF EVIDENCE: Level 3.