Outcome and cost analysis of bilateral sequential same-day cartilage tympanoplasty

Olusesi, A.D. et al. & Oyeniran, O. (2017) The Journal of Laryngology & Otology. 131(5)  pp. 399-403

Few studies have compared bilateral same-day with staged tympanoplasty using cartilage graft materials.

A prospective randomised observational study was performed of 38 chronic suppurative otitis media patients (76 ears) who were assigned to undergo bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential tympanoplasty performed 3 months apart (20 patients, 40 ears). Disease duration, intra-operative findings, combined duration of surgery, post-operative graft appearance at 6 weeks, post-operative complications, re-do rate and relative cost of surgery were recorded.

Tympanic membrane perforations were predominantly subtotal (p = 0.36, odds ratio = 0.75). Most grafts were harvested from the conchal cartilage and fewer from the tragus (p = 0.59, odds ratio = 1.016). Types of complication, post-operative hearing gain and revision rates were similar in both patient groups.

Surgical outcomes are not significantly different for same-day and bilateral cartilage tympanoplasty, but same-day surgery has the added benefit of a lower cost.

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Cost-Effectiveness of Watchful Waiting in Acute Otitis Media

Sun, D. et al. (2017) Pediatrics. 139(4) e20163086

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Background: American Academy of Pediatrics guidelines for acute otitis media (AOM) allow for children meeting certain criteria to undergo watchful waiting (WW). The cost-effectiveness of this policy has not been evaluated in the United States.

 

Conclusions: WW for AOM management is cost-effective. Implementing WW may improve outcomes and reduce health care expenditures.

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