Malhotra Raj, Khan Hamza, Zaransky Sydney, Celidonio Joseph, Yan Kenneth, Kaye Rachel
Rutgers New Jersey Medical School Newark New Jersey USA.
Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA.
OTO Open. 2024 Oct 15;8(4):e70014. doi: 10.1002/oto2.70014. eCollection 2024 Oct-Dec.
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.
PubMed, Scopus, EMBASE.
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.
Common presentations of R-CPD include abelchia (100%), abdominal bloating (83%), and gurgling noises (75%). 554 (86.9%) patients had improved symptoms after initial treatment with BTX. The most common initial dose was 50 units in 204 (37.3%) patients. Subsequent BTX injections resolved symptoms in 40 (80%) patients. Six patients ultimately received CP myotomy for recurrent symptoms, resulting in long-term resolution in 4 (67%) patients.
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.
自2019年3月首次被描述以来，逆行性环咽肌功能障碍（R-CPD）是一种认知度迅速上升的综合征。因此，目前文献中报道的R-CPD病例很少。本研究的目的是对有关R-CPD的现有文献进行全面的系统评价，包括患者特征、诊断和管理。
PubMed、Scopus、EMBASE。
使用PubMed、Scopus和EMBASE数据来源对现有的英文文献进行系统评价。纳入具有R-CPD典型症状患者原始数据的研究。进行独立的摘要筛选，随后进行全文筛选以评估研究的 eligibility。随后进行患者人口统计学、症状、治疗和随访的数据提取。
R-CPD的常见表现包括呃逆（100%）、腹胀（83%）和咕噜声（75%）。554例（86.9%）患者在初次使用肉毒杆菌毒素（BTX）治疗后症状改善。最常见的初始剂量为50单位，204例（37.3%）患者使用此剂量。随后的BTX注射使40例（80%）患者症状缓解。6例患者最终因症状复发接受了环咽肌切开术，4例（67%）患者症状得到长期缓解。
R-CPD是一种新认识的综合征，有包括肉毒杆菌毒素注射和适当情况下的环咽肌切开术等有效的治疗选择。包括食管测压在内的诊断方法可能有助于R-CPD的初步检查，然而需要进一步研究来评估其诊断效用。
