Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-22T14:10:56.941Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective

Published online by Cambridge University Press:  06 July 2017

D Chandran ,
C M Woods ,
M Schar ,
N Ma ,
E H Ooi  and
T Athanasiadis
D Chandran
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia
C M Woods
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia
M Schar
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia
N Ma
Affiliation:
School of Population Health, University of Adelaide, South Australia, Australia
E H Ooi*
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia
T Athanasiadis
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia Adelaide and Hills ENT Adelaide Voice Specialists, South Australia, Australia
*
Address for correspondence: A/Prof Eng H Ooi, Otolaryngology, Head and Neck Surgery, Department of Surgery, Flinders Medical Centre and Flinders University, Bedford Park, Adelaide, SA 5042, Australia E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia.

Methods:

The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time.

Results:

A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p < 0.001). The mean operating theatre time, surgeon procedure time and length of stay were all significantly lower under local anaesthesia compared to general anaesthesia. Time variables such as operating theatre time and length of stay were the most significant predictors of the total costs.

Conclusion:

Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

Keywords

LaryngoplastyOffice SurgeryHyaluronic AcidVocal Cord Paralysis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 2 , February 2018 , pp. 168 - 172
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Aviv, JE, Takoudes, TG, Ma, G, Close, LG. Office-based esophagoscopy: a preliminary report. Otolaryngol Head Neck Surg 2001;125:170–5Google Scholar
2 Bové, MJ, Jabbour, N, Krishna, P, Flaherty, K, Saul, M, Wunar, R et al. Operating room versus office-based injection laryngoplasty: a comparative analysis of reimbursement. Laryngoscope 2007;117:226–30Google Scholar
3 Birkent, H, Sardesai, M, Hu, A, Merati, AL. Prospective study of voice outcomes and patient tolerance of in-office percutaneous injection laryngoplasty. Laryngoscope 2013;123:1759–62Google Scholar
4 Mathison, CC, Villari, CR, Klein, AM, Johns, MM. Comparison of outcomes and complications between awake and asleep injection laryngoplasty: a case-control study. Laryngoscope 2009;119:1417–23Google Scholar
5 Andrade Filho, PA, Carrau, RL, Buckmire, RA. Safety and cost-effectiveness of intra-office flexible videolaryngoscopy with transoral vocal fold injection in dysphagic patients. Am J Otolaryngol 2006;27:319–22Google Scholar
6 Chandran, D, Woods, C, Ullah, S, Ooi, E, Athanasiadis, T. A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience. J Laryngol Otol 2017;131:S41–6 CrossRefGoogle ScholarPubMed
7 Ford, CN, Roy, N, Sandage, M, Bless, DM. Rigid endoscopy for monitoring indirect vocal fold injection. Laryngoscope 1998;108:1584–6Google Scholar
8 Rosen, CA, Amin, MR, Sulica, L, Simpson, CB, Merati, AL, Courey, MS et al. Advances in office-based diagnosis and treatment in laryngology. Laryngoscope 2009;119:S185–212 Google Scholar
9 Belafsky, P. The golden age of laryngology. Curr Opin Otolaryngol Head Neck Surg 2006;14:423–4Google Scholar
10 Rees, CJ, Postma, GN, Koufman, JA. Cost savings of unsedated office-based laser surgery for laryngeal papillomas. Ann Otol Rhinol Laryngol 2007;116:45–8Google Scholar
11 Grant, JR, Hartemink, DA, Patel, N, Merati, AL. Acute and subacute awake injection laryngoplasty for thoracic surgery patients. J Voice 2008;22:245–50Google Scholar
12 Amin, MR. Thyrohyoid approach for vocal fold augmentation. Ann Otol Rhinol Laryngol 2006;115:699–702 Google Scholar
13 Dedo, HH, Urrea, RD, Lawson, L. Intracordal injection of Teflon in the treatment of 135 patients with dysphonia. Ann Otol Rhinol Laryngol 1973;82:661–7Google Scholar
14 Ward, PH, Hanson, DG, Abemayor, E. Transcutaneous Teflon injection of the paralyzed vocal cord: a new technique. Laryngoscope 1985;95:644–9Google Scholar
15 Pearl, AW, Woo, P, Ostrowski, R, Mojica, J, Mandell, DL, Costantino, P. A preliminary report on micronized AlloDerm injection laryngoplasty. Laryngoscope 2002;112:990–6Google Scholar
16 Morris, KT, Pommier, RF, Vetto, JT. Office-based wire-guided open breast biopsy under local anesthesia is accurate and cost effective. Am J Surg 2000;179:422–5Google Scholar
17 DiCicco, JD, Ostrum, RF, Martin, B. Office removal of tibial external fixators: an evaluation of cost savings and patient satisfaction. J Orthop Trauma 1998;12:569–71Google Scholar
18 Luchtefeld, MA, Kim, DG. Colonoscopy in the office setting is safe, and financially sound … for now. Dis Colon Rectum 2006;49:377–82Google Scholar