A National Survey on Retrograde Cricopharyngeus Dysfunction Practice Patterns Among Laryngologists

OBJECTIVE: Retrograde cricopharyngeus dysfunction (RCPD) is characterized by the inability to belch, abdominal bloating, and distension, as well as socially awkward gurgling noises and excessive flatulence. The use of various diagnostic tools remains variable, while the national incidence of preference among laryngologists toward management remains unknown. This study aims to analyze trends and practice patterns in the diagnostic workup and management of RCPD among academic laryngologists. By doing so, our goal is to elucidate clinical decision-making patterns and treatment outcomes associated with the management strategies for RCPD. METHODS: An electronic survey was sent to 184 academic laryngologists. The survey assessed RCPD topics related to patient demographics, clinical characteristics, knowledge and experience levels, perceived importance of historical and physical factors in diagnosis, diagnostic workup and utility, the effectiveness of different management approaches, and specifics of botulinum toxin (BT) injection practices. RESULTS: Of the 87 (47.2%) laryngologists who responded to the survey, 75.9% have heard of RCPD before. The most common management approaches were BT injections (79.2%) and cricopharyngeus myotomy (11.3%). The mean amount of BT injected by laryngologists was 59 units. CONCLUSION: The survey demonstrates that RCPD is likely conceived as a clinical diagnosis among practicing laryngologists. While BT injections are done more frequently and are perceived to be effective, the role of myotomy of the cricopharyngeus remains variable. LEVEL OF EVIDENCE: 5: