Perioperative cost evaluation of canal wall down mastoidectomy.
INTRODUCTION
To evaluate perioperative costs of canal wall-down (CWD) mastoidectomy as an initial surgery compared to revision surgery following initial canal wall-up (CWU) mastoidectomy.


METHODS
This study is a retrospective chart review of adult patients who underwent CWD mastoidectomy for chronic otitis media with or without cholesteatoma at a tertiary referral center. Patients were divided into groups that had previous CWU surgery and were undergoing revision CWD and those that were having an initial CWD mastoidectomy. Cost variables including previous surgeries, imaging costs, audiometric testing, and post-operative visits were compared between the two groups using t-test analysis.


RESULTS
There was no significant difference with regards to the cost of post-operative visits, peri-operative imaging, or revision surgeries between the two groups. Hearing outcomes based on mean speech reception threshold (SRT) were not statistically different between the two groups (p = 0.087). There was a significant difference in total cost with the revision group having a higher mean cost by $6967.84, most of which was accounted for by the difference in the cost of the previous surgeries of $6488.53.


CONCLUSIONS
The revision CWD surgery group had increased total cost that could be attributed to the cost of previous surgery. Increased peri-operative cost was not noted with the initial CWD surgery group for any individual variables examined. Initial CWD mastoidectomy should be considered in the proper patient population to help decrease healthcare costs.
['Conway|Robert M|RM|', 'Sioshansi|Pedrom C|PC|', 'Howard|Anthony L|AL|', 'Babu|Seilesh C|SC|']
D000293:Adolescent D000328:Adult D000368:Aged D001299:Audiometry D002781:Cholesteatoma D002908:Chronic Disease D017046:Cost Savings D003365:Costs and Cost Analysis D003952:Diagnostic Imaging D005260:Female D006801:Humans D008297:Male D000074406:Mastoidectomy D008875:Middle Aged D009819:Office Visits D010033:Otitis Media D059035:Perioperative Period D011182:Postoperative Care D012086:Reoperation D012189:Retrospective Studies D055815:Young Adult
Cost evaluation Canal wall down mastoidectomy Chronic otitis media Cholesteatoma