How I Do It: The Transtracheal Approach for Awake Cricopharyngeal Botulinum Toxin Injection

This transtracheal technique for cricopharyngeal botulinum toxin injection is a safe and effective option for chemodenervation of this muscle in the awake patient. Its advantages include reduced risk of toxin spread to intrinsic laryngeal muscles, the ability to administer higher doses of botulinum toxin, improved access to the entire length of the cricopharyngeus, and avoidance of general anesthesia.