Sometimes you need a doctor
When conservative home treatments are not effective in managing symptoms of retrograde cricopharyngeus dysfunction (R-CPD), there are several medical procedures doctors may recommend. The pathology of R-CPD is related to improper relaxation of the upper esophageal sphincter. Doctors can provide treatments to address the muscular dysfunction and help you swallow more normally.
Botulinum toxin
The most common doctor-administered treatment for R-CPD is botox injections. Botox is injected directly into the cricopharyngeus muscle at the upper esophageal sphincter, which paralyzes the muscle and prevents it from constricting. This allows food and liquids to pass through more easily. The effect of the botox injections typically lasts around 3 months before a repeat injection is needed.
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Cricopharyngeal myotomy
Sometimes botox provides only temporary or incomplete relief. In these cases, a procedure called cricopharyngeal myotomy surgery may be recommended. This is a minimally invasive operation where a small incision is made in the neck, allowing the surgeon to cut a portion of the cricopharyngeus muscle. Permanently disrupting part of the muscle helps weaken it and prevent constriction of the esophagus.
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Sphincter dilation
Dilatation of the upper esophageal sphincter is done by inserting a dilator instrument through the mouth and gently opening the sphincter with applied pressure. Repeated dilations can lengthen and stretch open the sphincter over time. However, this procedure usually provides only temporary improvement.
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Open myotomy
For the most severe and persistent cases of R-CPD, surgeons can perform an open cricopharyngeal myotomy. This more invasive open surgery allows the cricopharyngeus muscle to be completely cut. However, it requires a larger incision in the neck and has a longer recovery time.
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