{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:58:33Z","timestamp":1779400713324,"version":"3.53.1"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>This scoping review aimed to summarize the current literature on the etiological and pathophysiological mechanisms associated with the development of retrograde cricopharyngeus dysfunction (R-CPD) through a PRISMA literature search. According to the current literature, a family history of R-CPD was reported in 28.0% of patients across studies, with childhood onset in 55.5% of cases. Gastroesophageal reflux disease and laryngopharyngeal reflux disease prevalence in R-CPD patients ranged from 16.3 to 51.9%, with improvement of heartburn symptoms after treatment. High-resolution manometry revealed dysmotility disorders in 43.5\u201380.0% of patients, with absent peristalsis in 11\u201325%. Carbonated drink provocative testing provided diagnostic usefulness in patients with unclear diagnoses by demonstrating failure of cricopharyngeal sphincter relaxation for retrograde gas. Notably, 75.5\u201379.9% of patients maintained symptom relief beyond the expected pharmacologic duration of botulinum toxin (approximately 6 months), suggesting potential neuroplastic adaptation or learned compensatory mechanisms in overcoming retrograde cricopharyngeal sphincter dysfunction. The pathophysiology of R-CPD remains incompletely understood, with a lack of epidemiological and pediatric studies. The genetic and environmental factors may play a key role, but future studies are needed to clarify their roles in the development of R-CPD.<\/jats:p>","DOI":"10.3390\/toxins18010008","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T14:27:51Z","timestamp":1766586471000},"page":"8","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrograde Cricopharyngeal Dysfunction: An Update of Pathophysiological Mechanisms and Future Directions"],"prefix":"10.3390","volume":"18","author":[{"given":"Marie","family":"Mailly","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, 91190 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"Jerome R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, 91190 Paris, France"},{"name":"Department of Surgery, UMONS Research Institute for Language Science and Technology, University of Mons (UMons), 7000 Mons, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/0016-5085(87)90445-8","article-title":"Dysfunction of the belch reflex. 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