(0811) Diagnosis and Management of Retrograde Cricopharyngeal Dysfunction: A Systematic Review

Introduction: Retrograde cricopharyngeal dysfunction (R-CPD) is a syndrome with rapidly increasing awareness since being first described in March 2019. As such, few cases of R-CPD are currently reported in the literature. The goal of this study is to provide a comprehensive systematic review of the available literature on R-CPD, including patient characteristics, diagnosis, and management.

Methods: A systematic review of the available English literature was conducted using the data sources PubMed, Scopus, and EMBASE. Studies with original data of patients experiencing classic symptoms of R-CPD were included. Independent abstract screening followed by full-text screening was performed to assess study eligibility. Data extraction of patient demographics, symptoms, treatment, and follow-up were subsequently performed.

Results: Common presentations of R-CPD include abelchia (100%), abdominal bloating (75%), and gurgling noises (61%). In total, 204 (65%) patients received 50 units BT injection for management of the syndrome. A second BT injection resolved symptoms in 35/47 (74%) of patients. Due to unresolving symptoms post-injection, 6 out of 397 patients received CP myotomy for refractory symptoms, resulting in resolution in 6/6 patients.

Conclusions: R-CPD is a newly recognized syndrome with effective treatment options including botulinum toxin injections and cricopharyngeal myotomy, where appropriate. Diagnostic modalities including esophageal manometry may aid in the initial work up of R-CPD, however further studies are required to assess its diagnostic utility.