CP and infection: When conservative treatments fail, surgical management approaches such as myotomy can be effective.[5] However, myotomy is highly invasive and carries risks of infection, salivary fistula formation, and recurrent laryngeal nerve injury.[9] In addition, myotomy does not alter the contractile forces of the CP muscle and therefore may not benefit every patient.[9,10] Since BTX injection of CP muscle was initially described in 1994,[11] many studies have performed this technique.