{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T14:54:50Z","timestamp":1786460090158,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Little data currently exists on endoscopic findings in patients with Retrograde cricopharyngeus dysfunction (R\u2010CPD), particularly regarding factors that may help predict treatment outcomes. Here, we describe the previously unreported prevalence of cervical esophageal inlet patches (CIP) among patients undergoing treatment for R\u2010CPD and evaluate their association with treatment responses while controlling for other patient\u2010specific factors.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a retrospective cohort review performed on patients undergoing cricopharyngeal botulinum toxin injection (CPBTI) as treatment for R\u2010CPD. Demographics, patient\u2010specific factors, and endoscopic findings, including the presence of CIP, were noted. Early and long\u2010term treatment responses following CPBTI were recorded at 6\u2009weeks and \u20096\u2009months posttreatment, respectively. Univariate and multivariate analyses were performed to assess associations among endoscopy findings, demographic data, and treatment response at both time points.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 101 patients (average age: 29.2\u2009years, 68.3% female) underwent cervical esophagoscopy with CPBTI. Twenty (19.8%) had one or more CIP in the proximal esophagus. Of 76 patients who also received concurrent flexible esophagogastroscopy, 28 (37.8%) had a hiatal hernia and 34 (44.7%) had distal esophageal mucosal abnormalities. CIP and increasing age were the only significant predictors in this study, with both predicting failure to sustain a long\u2010term treatment response (CIP: OR 5.14, 95% CI 1.60\u201316.50,\n p<\/jats:italic>\n \u2009=\u20090.006; increasing age: OR 1.09, 95% CI 1.03\u20131.14,\n p<\/jats:italic>\n \u2009=\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n There is a high prevalence of CIP in R\u2010CPD patients, which, along with increasing age, portends significantly increased odds of failure to sustain a long\u2010term treatment response following an initially successful CPBTI.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70782","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:29:51Z","timestamp":1786451391000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervical Inlet Patches in R\u2010\n CPD<\/scp>\n : An Unrecognized Predictor of Treatment Failure"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1350-0445","authenticated-orcid":false,"given":"Andrew Geoffrey","family":"Tritter","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head & Neck Surgery UTHealth Houston, McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9221-499X","authenticated-orcid":false,"given":"Nabeeha","family":"Hasan","sequence":"additional","affiliation":[{"name":"UTHealth Houston, McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jered","family":"Wilson","sequence":"additional","affiliation":[{"name":"UTHealth Houston, McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.1177\/2473974X19834553","article-title":"Inability to Belch and Associated Symptoms due to Retrograde Cricopharyngeus Dysfunction: Diagnosis and Treatment","volume":"3","author":"Bastian R. 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H.","year":"2024","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"4147","DOI":"10.1002\/lary.32322","article-title":"Office v OR Injection for Retrograde Cricopharyngeal Dysfunction: Evidence\u2010Based Treatment Algorithm","volume":"135","author":"Kutler R. B.","year":"2025","journal-title":"Laryngoscope"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13020413","article-title":"Retrograde Cricopharyngeal Dysfunction: A Review","volume":"13","author":"Miller M. E.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.5056\/jnm23099","article-title":"Retrograde Cricopharyngeus Dysfunction, a New Motility Disorder: Single Center Case Series and Treatment Results","volume":"30","author":"Arnaert S.","year":"2024","journal-title":"Journal of Neurogastroenterology and Motility"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","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 C.","year":"2024","journal-title":"Laryngoscope"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/lary.30871","article-title":"Lateral Transcervical in\u2010Office Botulinum Toxin Injection for Retrograde Cricopharyngeal Dysfunction","volume":"134","author":"Doruk C.","year":"2024","journal-title":"Laryngoscope"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"3111","DOI":"10.1002\/lary.70478","article-title":"Can Intraoperative Cricopharyngeus Muscle Characteristics be Used to Predict Treatment Success in RCPD?","volume":"136","author":"Lee E.","year":"2026","journal-title":"Laryngoscope"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"4061","DOI":"10.3748\/wjg.v25.i30.4061","article-title":"Issues and Controversies in Esophageal Inlet Patch","volume":"25","author":"Ciocalteu A.","year":"2019","journal-title":"World Journal of Gastroenterology"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1136\/gut.32.9.968","article-title":"Incidence of Heterotopic Gastric Mucosa in the Upper Oesophagus","volume":"32","author":"Borhan\u2010Manesh F.","year":"1991","journal-title":"Gut"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1002\/ar.1092170405","article-title":"Maturation of Human Fetal Esophagus Maintained in Organ Culture","volume":"217","author":"Menard D.","year":"1987","journal-title":"Anatomical Record"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"e250","DOI":"10.1097\/MCG.0000000000001516","article-title":"Prevalence and Clinical and Endoscopic Characteristics of Cervical Inlet Patch (Heterotopic Gastric Mucosa): A Systematic Review and Meta\u2010Analysis","volume":"56","author":"Yin Y.","year":"2022","journal-title":"Journal of Clinical Gastroenterology"},{"key":"e_1_2_10_16_1","first-page":"3127","article-title":"The True Prevalence of Cervical Inlet Patch in a Specific Center Dealing With Esophageal Diseases","volume":"26","author":"Akar T.","year":"2022","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1007\/s00535-010-0275-8","article-title":"Non\u2010Erosive Reflux Disease Rather Than Cervical Inlet Patch Involves Globus","volume":"45","author":"Hori K.","year":"2010","journal-title":"Journal of Gastroenterology"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s12876-017-0644-3","article-title":"The Prevalence of Gastric Heterotopia of the Proximal Esophagus Is Underestimated, but Preneoplasia Is Rare \u2010 Correlation With Barrett's Esophagus","volume":"17","author":"Peitz U.","year":"2017","journal-title":"BMC Gastroenterology"},{"key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s00455-022-10492-8","article-title":"Heterotopic Gastric Mucosa in the Proximal Esophagus: Prospective Study and Systematic Review on Relationships With Endoscopic Findings and Clinical Data","volume":"38","author":"Romanczyk M.","year":"2023","journal-title":"Dysphagia"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.14309\/ajg.0000000000003242","article-title":"Prospective Controlled Study of Endoscopic Botulinum Toxin Injection for Retrograde Cricopharyngeus Dysfunction: The Inability to Belch Syndrome","volume":"120","author":"Sanagapalli S.","year":"2024","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","DOI":"10.1111\/nmo.14328","article-title":"Retrograde Upper Esophageal Sphincter Function and Dysfunction","volume":"34","author":"Kahrilas P. J.","year":"2022","journal-title":"Neurogastroenterology and Motility"},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.3748\/wjg.v19.i3.331","article-title":"Clinical Significance of Heterotopic Gastric Mucosal Patch of the Proximal Esophagus","volume":"19","author":"Chong V. H.","year":"2013","journal-title":"World Journal of Gastroenterology"},{"key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/j.1572-0241.2004.04082.x","article-title":"Heterotopic Gastric Mucosa of the Esophagus: Literature\u2010Review and Proposal of a Clinicopathologic Classification","volume":"99","author":"Rahden B. H.","year":"2004","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1002\/lary.32125","article-title":"A National Survey on Retrograde Cricopharyngeus Dysfunction Practice Patterns Among Laryngologists","volume":"135","author":"Razura D. 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P.","year":"2026","journal-title":"Laryngoscope"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1002\/jpn3.12193","article-title":"Pediatric Retrograde Cricopharyngeal Dysfunction Diagnosed by High\u2010Resolution Impedance Manometry","volume":"78","author":"Dorfman L.","year":"2024","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijporl.2022.111261","article-title":"\u201cI've Never Been Able to Burp\u201d: Preliminary Description of Retrograde Cricopharyngeal Dysfunction in Children","volume":"161","author":"Hoffman M. R.","year":"2022","journal-title":"International Journal of Pediatric Otorhinolaryngology"},{"key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1080\/08998280.2023.2255510","article-title":"The Kid Who Couldn't Burp: The Management of a Pediatric Case of Retrograde Cricopharyngeal Dysfunction","volume":"36","author":"Mitchell M.","year":"2023","journal-title":"Baylor University Medical Center Proceedings"},{"key":"e_1_2_10_34_1","doi-asserted-by":"crossref","DOI":"10.1111\/nmo.14721","article-title":"Retrograde Cricopharyngeus Dysfunction: How Does the Inability to Burp Affect Daily Life?","volume":"36","author":"Chen J. N.","year":"2024","journal-title":"Neurogastroenterology and Motility"},{"key":"e_1_2_10_35_1","doi-asserted-by":"crossref","DOI":"10.1177\/19160216251329012","article-title":"Etiology, Clinical Presentation, and Management of Retrograde Cricopharyngeus Dysfunction: A Systematic Review","volume":"54","author":"Lechien J. R.","year":"2025","journal-title":"Journal of Otolaryngology \u2010 Head & Neck Surgery"},{"key":"e_1_2_10_36_1","doi-asserted-by":"crossref","first-page":"5087","DOI":"10.1007\/s00405-021-06790-w","article-title":"Abelchia: Inability to Belch\/Burp\u2010a New Disorder? Retrograde Cricopharyngeal Dysfunction (RCPD)","volume":"278","author":"Karagama Y.","year":"2021","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_10_37_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s00455-020-10159-2","article-title":"Influence of Acid Swallows on the Dynamics of the Upper Esophageal Sphincter","volume":"36","author":"Miller S.","year":"2021","journal-title":"Dysphagia"},{"key":"e_1_2_10_38_1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1002\/ohn.735","article-title":"Upper Esophageal Sphincter and Esophageal Motility Pathology on Manometry in Retrograde Cricopharyngeal Dysfunction","volume":"171","author":"Yousef A.","year":"2024","journal-title":"Otolaryngology and Head and Neck Surgery"},{"key":"e_1_2_10_39_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/MOG.0000000000001177","article-title":"Retrograde Cricopharyngeus Dysfunction: What the Gastroenterologist Should Know","volume":"42","author":"Lechien J. 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