Cost-effectiveness of transfacial gland-preserving removal of parotid sialoliths

Adrian A. Ong, William Wise Crosby Carroll, Shaun A. Nguyen, M. Boyd Gillespie

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: Examine outcomes of transfacial gland-preserving removal of difficult parotid stones and compare the cost and operative time to traditional parotidectomy. Study Design: Cost-effectiveness analysis and retrospective chart review. Methods: Patients who underwent transfacial removal of symptomatic parotid sialoliths at a tertiary medical center from June 2010 to July 2015 were evaluated. Outcomes included operative technique, stone size, stone location, complications, and symptom relief. In addition, patients who underwent traditional parotidectomy for chronic sialadenitis were identified. The charges and times for both procedures were reviewed and compared. Results: Forty-four patients underwent transfacial resection for symptomatic parotid sialolithiasis. Stones were most often located in the main duct and hilum (53.3%), with fewer intraglandular stones (46.7%). No facial nerve weakness was observed. Of those with follow-up, 33 (87%) patients reported at least partial resolution of symptoms. Overall transfacial technique charges were significantly less expensive (U.S.$) than parotidectomy (mean difference −8,064.09; 95% confidence interval [CI] −13,472.78 to −2,655.40; P = 0.033). Anesthesia charges (mean difference −2,997.85; 95% CI, −5,748.81 to −246.89; P = 0.035) and operating room charges (mean difference −4,793.91; 95% CI, −8,958.09 to −629.72; P = 0.028) were also less expensive for the transfacial technique. Finally, mean procedure time for transfacial removal of parotid stones was shorter than for parotidectomy (120.2 ± 49.9 vs. 178.4 ± 41.3 minutes, respectively; P = 0.002). Conclusion: Transfacial gland-preserving removal of difficult parotid stones is a well tolerated and effective alternative to parotidectomy. Moreover, it is faster and less expensive than parotidectomy, maximizing both surgeon time and hospital resources. Level of Evidence: 4. Laryngoscope, 127:1080–1086, 2017.

Original languageEnglish (US)
Pages (from-to)1080-1086
Number of pages7
JournalLaryngoscope
Volume127
Issue number5
DOIs
StatePublished - May 1 2017
Externally publishedYes

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Salivary Gland Calculi
Cost-Benefit Analysis
Confidence Intervals
Sialadenitis
Laryngoscopes
Facial Nerve
Operating Rooms
Operative Time
Anesthesia
Costs and Cost Analysis

Keywords

  • Sialolithiasis
  • cost-effectiveness analysis
  • economic evaluation
  • parotid
  • salivary endoscopy
  • salivary stones

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Cost-effectiveness of transfacial gland-preserving removal of parotid sialoliths. / Ong, Adrian A.; Carroll, William Wise Crosby; Nguyen, Shaun A.; Gillespie, M. Boyd.

In: Laryngoscope, Vol. 127, No. 5, 01.05.2017, p. 1080-1086.

Research output: Contribution to journalArticle

Ong, Adrian A. ; Carroll, William Wise Crosby ; Nguyen, Shaun A. ; Gillespie, M. Boyd. / Cost-effectiveness of transfacial gland-preserving removal of parotid sialoliths. In: Laryngoscope. 2017 ; Vol. 127, No. 5. pp. 1080-1086.
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abstract = "Objective: Examine outcomes of transfacial gland-preserving removal of difficult parotid stones and compare the cost and operative time to traditional parotidectomy. Study Design: Cost-effectiveness analysis and retrospective chart review. Methods: Patients who underwent transfacial removal of symptomatic parotid sialoliths at a tertiary medical center from June 2010 to July 2015 were evaluated. Outcomes included operative technique, stone size, stone location, complications, and symptom relief. In addition, patients who underwent traditional parotidectomy for chronic sialadenitis were identified. The charges and times for both procedures were reviewed and compared. Results: Forty-four patients underwent transfacial resection for symptomatic parotid sialolithiasis. Stones were most often located in the main duct and hilum (53.3{\%}), with fewer intraglandular stones (46.7{\%}). No facial nerve weakness was observed. Of those with follow-up, 33 (87{\%}) patients reported at least partial resolution of symptoms. Overall transfacial technique charges were significantly less expensive (U.S.$) than parotidectomy (mean difference −8,064.09; 95{\%} confidence interval [CI] −13,472.78 to −2,655.40; P = 0.033). Anesthesia charges (mean difference −2,997.85; 95{\%} CI, −5,748.81 to −246.89; P = 0.035) and operating room charges (mean difference −4,793.91; 95{\%} CI, −8,958.09 to −629.72; P = 0.028) were also less expensive for the transfacial technique. Finally, mean procedure time for transfacial removal of parotid stones was shorter than for parotidectomy (120.2 ± 49.9 vs. 178.4 ± 41.3 minutes, respectively; P = 0.002). Conclusion: Transfacial gland-preserving removal of difficult parotid stones is a well tolerated and effective alternative to parotidectomy. Moreover, it is faster and less expensive than parotidectomy, maximizing both surgeon time and hospital resources. Level of Evidence: 4. Laryngoscope, 127:1080–1086, 2017.",
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N2 - Objective: Examine outcomes of transfacial gland-preserving removal of difficult parotid stones and compare the cost and operative time to traditional parotidectomy. Study Design: Cost-effectiveness analysis and retrospective chart review. Methods: Patients who underwent transfacial removal of symptomatic parotid sialoliths at a tertiary medical center from June 2010 to July 2015 were evaluated. Outcomes included operative technique, stone size, stone location, complications, and symptom relief. In addition, patients who underwent traditional parotidectomy for chronic sialadenitis were identified. The charges and times for both procedures were reviewed and compared. Results: Forty-four patients underwent transfacial resection for symptomatic parotid sialolithiasis. Stones were most often located in the main duct and hilum (53.3%), with fewer intraglandular stones (46.7%). No facial nerve weakness was observed. Of those with follow-up, 33 (87%) patients reported at least partial resolution of symptoms. Overall transfacial technique charges were significantly less expensive (U.S.$) than parotidectomy (mean difference −8,064.09; 95% confidence interval [CI] −13,472.78 to −2,655.40; P = 0.033). Anesthesia charges (mean difference −2,997.85; 95% CI, −5,748.81 to −246.89; P = 0.035) and operating room charges (mean difference −4,793.91; 95% CI, −8,958.09 to −629.72; P = 0.028) were also less expensive for the transfacial technique. Finally, mean procedure time for transfacial removal of parotid stones was shorter than for parotidectomy (120.2 ± 49.9 vs. 178.4 ± 41.3 minutes, respectively; P = 0.002). Conclusion: Transfacial gland-preserving removal of difficult parotid stones is a well tolerated and effective alternative to parotidectomy. Moreover, it is faster and less expensive than parotidectomy, maximizing both surgeon time and hospital resources. Level of Evidence: 4. Laryngoscope, 127:1080–1086, 2017.

AB - Objective: Examine outcomes of transfacial gland-preserving removal of difficult parotid stones and compare the cost and operative time to traditional parotidectomy. Study Design: Cost-effectiveness analysis and retrospective chart review. Methods: Patients who underwent transfacial removal of symptomatic parotid sialoliths at a tertiary medical center from June 2010 to July 2015 were evaluated. Outcomes included operative technique, stone size, stone location, complications, and symptom relief. In addition, patients who underwent traditional parotidectomy for chronic sialadenitis were identified. The charges and times for both procedures were reviewed and compared. Results: Forty-four patients underwent transfacial resection for symptomatic parotid sialolithiasis. Stones were most often located in the main duct and hilum (53.3%), with fewer intraglandular stones (46.7%). No facial nerve weakness was observed. Of those with follow-up, 33 (87%) patients reported at least partial resolution of symptoms. Overall transfacial technique charges were significantly less expensive (U.S.$) than parotidectomy (mean difference −8,064.09; 95% confidence interval [CI] −13,472.78 to −2,655.40; P = 0.033). Anesthesia charges (mean difference −2,997.85; 95% CI, −5,748.81 to −246.89; P = 0.035) and operating room charges (mean difference −4,793.91; 95% CI, −8,958.09 to −629.72; P = 0.028) were also less expensive for the transfacial technique. Finally, mean procedure time for transfacial removal of parotid stones was shorter than for parotidectomy (120.2 ± 49.9 vs. 178.4 ± 41.3 minutes, respectively; P = 0.002). Conclusion: Transfacial gland-preserving removal of difficult parotid stones is a well tolerated and effective alternative to parotidectomy. Moreover, it is faster and less expensive than parotidectomy, maximizing both surgeon time and hospital resources. Level of Evidence: 4. Laryngoscope, 127:1080–1086, 2017.

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