Botulinum Toxin Injection under Electromyography Guidance for the Treatment of Primary Dysfunction of Cricopharyngeal Muscle

Cricopharyngeal dysfunction produces dysphagia of different severity. The treatment of this entity attempts to diminish the muscular hyperfunction by means of different techniques.

The aim of this article is to describe the injection technique, as well as showing the outcomes. The injection in the office setting saves the costs of an operating room and alleviates the patients stress associated to a surgical intervention. EMG guidance allows an accurate localization of the muscle with a minimum discomfort for the patient secondary to the needle insertion.

The non-invasive injection technique of botulinum toxin under electromyography guidance is described thoroughly. We present the management of 3 patients presenting this disorder, accompanied by images before and after the procedure.

Results showed a well-tolerated safe technique, with no complications and optimal results in terms of symptoms amelioration. All patients presented an improvement of the cricopharyngeal dysfunction following the injection with a decrease in the clinical manifestations previously related, without complications related to the procedure.

We confirm the results of previous studies and consider this treatment as an optimal choice in the management of isolated dysfunction of the cricopharyngeal muscle, due to its good tolerance and successful outcomes.