{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:06:40Z","timestamp":1793383600733,"version":"4.5.0"},"reference-count":6,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"\n Importance<\/jats:title>\n Retrograde cricopharyngeus dysfunction (R-CPD) is an emerging disorder associated with disabling symptoms. The origin of R-CPD remains unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the development of symptoms, diagnosis approach, and therapeutic outcomes of R-CPD in patients treated with in-office botulinum toxin injection (BTI) into the cricopharyngeus.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a case series including patients with R-CPD who were consecutively and prospectively recruited from April 2022 to May 2024 in an academic hospital. Semistructured interviews were conducted to collect and analyze data on each patient\u2019s clinical history, potential causes or factors associated with R-CPD development, diagnostic approaches, and symptom presentation.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Clinic-based (in-office) BTI into the cricopharyngeus.<\/jats:p>\n <\/jats:sec>\n \n Outcomes and Measures<\/jats:title>\n Associations with laryngopharyngeal reflux disease, patients\u2019 Reflux Symptom Score-12 (RSS-12), and BTI effectiveness, revisions, and complications were evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The case series comprised 106 patients with R-CPD treated with BTI (52 females [49.1%] and 54 males [51.9%]). Their mean (SD) age at symptom onset was 13.6 (7.7) years, and at diagnosis, 30.4 (6.4) years. Sixty-eight patients (64.2%) had potential congenital R-CPD, according to the parents\u2019 testimonies. A family history was reported in 18 of 62 cases (29.0%). In 105 cases (99.1%), patients made the diagnosis themselves despite medical consultations (n\u2009=\u2009162), empirical treatments (n\u2009=\u2009113), and additional examinations (n\u2009=\u200992). The cumulative success rate of BTI was 90.6% (96 of 106 patients). In 26 cases (24.5%), additional injections were administered to address the symptoms. Family history of R-CPD was a negative predictor of single-BTI success. Dysphagia was the primary adverse effect occurring after 89 of 126 BTIs (70.6%) and lasted a mean (SD) of 16.3 (12.0) days. In 10 cases, operating-room BTI was administered after primary in-office BTI.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n R-CPD is an emerging and poorly known disorder associated with high rates of ineffective consultations, additional examinations, and self-diagnosis by patients. In-office BTI was associated with a high rate of partial or total symptom relief and long-term effectiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoto.2024.5046","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T11:32:25Z","timestamp":1738236745000},"page":"396","source":"Crossref","is-referenced-by-count":15,"title":["Origin and In-Office Treatment of Retrograde Cricopharyngeus Dysfunction"],"prefix":"10.1001","volume":"151","author":[{"given":"Marie","family":"Mailly","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Baudouin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Thibault","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Centre Hospitalier Universitaire (CHU) de Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Hans","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France"},{"name":"Department of Surgery, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium"},{"name":"Division of Laryngology and Broncho-esophagology, Department of Otolaryngology\u2013Head Neck Surgery, EpiCURA Hospital, Baudour, Belgium"},{"name":"Department of Otolaryngology, Elsan Polyclinic de l\u2019Atlantique, Poitiers, France"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"11","key":"obr240006r1","doi-asserted-by":"publisher","first-page":"4614","DOI":"10.1002\/lary.31591","article-title":"Botulinum toxin injection for retrograde cricopharyngeal dysfunction: a prospective cohort study.","volume":"134","author":"Doruk","year":"2024","journal-title":"Laryngoscope"},{"issue":"1","key":"obr240006r2","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X19834553","article-title":"Inability to belch and associated symptoms due to retrogradecricopharyngeus dysfunction: diagnosis and treatment.","volume":"3","author":"Bastian","year":"2019","journal-title":"OTO Open"},{"issue":"1","key":"obr240006r3","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1177\/0194599820941003","article-title":"Development and validation of the short version of the reflux symptom score: reflux symptom score-12.","volume":"164","author":"Lechien","year":"2021","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"obr240006r4","doi-asserted-by":"publisher","first-page":"263","DOI":"10.14309\/ajg.0000000000001061","article-title":"Hypercontractile esophagus from pathophysiology to management: proceedings of the pisa symposium.","volume":"116","author":"de Bortoli","year":"2021","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"obr240006r5","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s13054-021-03479-8","article-title":"Characterization of esophageal motor activity, gastroesophageal reflux, and evaluation of prokinetic effectiveness in mechanically ventilated critically ill patients: a high-resolution impedance manometry study.","volume":"25","author":"Balihar","year":"2021","journal-title":"Crit Care"},{"issue":"4","key":"obr240006r6","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1001\/jamaoto.2017.3088","article-title":"Outcomes of onabotulinum toxin a treatment for adductor spasmodic dysphonia and laryngeal tremor.","volume":"144","author":"Patel","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg"}],"container-title":["JAMA Otolaryngology\u2013Head & Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2829687\/jamaotolaryngology_mailly_2025_br_240006_1743795536.90913.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T11:01:15Z","timestamp":1744282875000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2829687"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2024.5046","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}