Radiofrequency ablation in patients with large cervical heterotopic gastric mucosa and globus sensation: Closing the treatment gap

Objectives Symptomatic cervical heterotopic gastric mucosa also addressed as cervical inlet patch (CIP) may present in varying shapes and causes symptoms of laryngopharyngeal reflux (LPR) like globus sensations, hoarseness and chronic cough. Unfortunately, argon plasma coagulation, standard treatment of small symptomatic CIP, is limited in large CIP mainly due to concerns of stricture formation. Therefore, we aimed to investigate radiofrequency ablation (RFA), a novel minimal-invasive ablation method, in the treatment of CIP focusing on large symptomatic patches. Methods Consecutive patients with macroscopic and histologic evidence of large (≥ 20mm diameter) heterotopic gastric mucosa were included in this prospective trial. Primary outcome was the complete macroscopic and histologic eradication rate of CIP. Secondary outcome measures were symptom improvement, quality of life, severity of LPR and adverse events. Results Ten patients (females, n=5) underwent RFA of symptomatic CIP. Complete histological and macroscopic eradication of CIP was observed in 80% (females, n=4) of individuals after 2 ablations. Globus sensations significantly improved from median VAS score 8 (5-9) at baseline to 1.5 (1-7) after first ablation and 1 (1-2) after final evaluation (p