Surgeon and hospital cost variability for septoplasty and inferior turbinate reduction

2016 ◽  
Vol 6 (10) ◽  
pp. 1069-1074 ◽  
Author(s):  
Andrew Thomas ◽  
Jeremiah Alt ◽  
Craig Gale ◽  
Sathya Vijayakumar ◽  
Reema Padia ◽  
...  
Keyword(s):  
Hospital Cost ◽  
Inferior Turbinate ◽  
Cost Variability ◽  
Turbinate Reduction

Time, Resident Involvement, and Supply Drive Cost Variability in Septoplasty with Turbinate Reduction

2018 ◽  
Vol 159 (2) ◽  
pp. 310-314 ◽  
Author(s):  
Nicholas A. Quinn ◽  
Jeremiah A. Alt ◽  
Shaelene Ashby ◽  
Richard R. Orlandi
Keyword(s):  
Operative Time ◽  
Tertiary Care ◽  
Inferior Turbinate ◽  
Junior Resident ◽  
Care Hospital ◽  
Total Cost ◽  
Resident Involvement ◽  
Cost Variability ◽  
Supply Costs ◽  
Turbinate Reduction

Objective To determine factors that influence cost variability in septoplasty with inferior turbinate reduction. Study Design Case series with chart review. Setting Tertiary care hospital and affiliated ambulatory surgical center. Subjects and Methods Surgical costs were reviewed for adult patients undergoing septoplasty with inferior turbinate reduction between December 2014 and September 2017. Cases where additional procedures were performed were excluded. Operative supply costs, operative time, room time, and resident involvement were determined. Contribution of these factors to total costs and variability were analyzed. Results The study included 116 patients (mean age, 38 years) and 4 faculty surgeons. Total cost was primarily driven by operative time (74%), with a smaller portion of total cost arising from supplies (26%). Time cost ( P < .0001) and supply cost ( P = .006) varied significantly among surgeons. A resident was involved in 46.6% of cases. When subanalyzed by resident year, no-resident and senior resident (postgraduate years 4 and 5) cases had nearly identical mean times, while junior resident (postgraduate years 1-3) cases had mean times and operative time costs that were 39% greater ( P < .001). Conclusion For septoplasty with inferior turbinate reduction, the greatest driver of cost variation was operative time. Resident involvement correlated with increased time and cost. Supply costs had a much smaller impact. When subanalyzed by resident year, junior resident–involved cases were significantly longer than no-resident cases.

Clinical Outcome of CO2 Laser Inferior Turbinate Reduction in Patients with Nasal Obstruction Due to Inferior Turbinate Hypertrophy in a Tertiary Care Centre, Thiruvananthapuram, Kerala

2021 ◽  
Vol 8 (30) ◽  
pp. 2778-2783
Author(s):  
Nikhila Rajendran ◽  
Jaya C ◽  
Venugopal M ◽  
Satheesh S
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Outcome ◽  
Medical Treatment ◽  
Nasal Obstruction ◽  
Co2 Laser ◽  
Inferior Turbinate ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy ◽  
Turbinate Reduction

BACKGROUND Nasal obstruction secondary to inferior turbinate hypertrophy significantly affects the quality of life. Patients refractory to medical treatment are taken up for surgery. Laser turbinate reduction is an effective and simple method for treatment of nasal obstruction due to inferior turbinate hypertrophy. Only a few studies reported on the outcome of laser inferior turbinate reduction in India. The present study was done to assess the clinical outcome of laser inferior turbinate reduction in patients with nasal obstruction due to inferior turbinate hypertrophy. METHODS This prospective observational study was done in 31 patients (18 – 60 years) with nasal obstruction due to inferior turbinate hypertrophy refractory to medical management who underwent laser inferior turbinate reduction in ENT Department, Government Medical College, Thiruvananthapuram from December 2017 to September 2019. RESULTS All patients had bilateral inferior turbinate hypertrophy. 21 out of 31 patients had allergic rhinitis and rest had non-allergic rhinitis. Pre-operatively most patients had symptom score between 15 and 20. After CO2 laser inferior turbinate reduction at the end of 3 months of follow up, subjective assessment by symptom scoring confirmed by objective assessment by flowmetry 29 out of 31 patients had good outcome with relief from nasal obstruction. The success rate was more in nonallergic rhinitis (100 %) than the allergic rhinitis group (90.47 %). CONCLUSIONS CO2 laser inferior turbinate reduction is an effective procedure to relieve nasal obstruction in patients with inferior turbinate hypertrophy refractory to medical treatment, with minimal complications. Post-procedure on follow up significant number of patients had relief from hyposmia, sneezing and running nose. KEYWORDS Nasal Obstruction, Peak Nasal Inspiratory Flowmetry, Symptom Scoring, CO2 Laser, Outcome

scholarly journals Inferior Turbinate Reduction: Diode LASER or Conventional Partial Turbinectomy?

2019 ◽  
pp. 014556131983979
Author(s):  
Venkatesh Doreyawar ◽  
Raveendra P. Gadag ◽  
Manjunath Dandinarasaiah ◽  
Shivalingappa B. Javali ◽  
Nagaraj Maradi ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Diode Laser ◽  
Controlled Trial ◽  
Inferior Turbinate ◽  
Conventional Technique ◽  
Intraoperative Bleeding ◽  
Pain Scores ◽  
Common Causes ◽  
Turbinate Reduction

Hypertrophy of inferior nasal turbinate is one of the most common causes for nasal obstruction (NO). As diode laser has proven to be as effective as any other lasers, our objective was to study various primary outcomes of its use of diode laser like improvement in NO, intraoperative bleeding, postoperative pain, and rapidity of healing. The study was undertaken to compare the various outcomes by diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT). A nonrandomized controlled trial was conducted on 2 groups: One group (30 cases) underwent LTR and PIT was performed in the other group (30 cases). The improvement in NO was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to fifth postoperative day. Lastly, rapidity of healing was evaluated until 6 months. Subjective relief of NO was 90.8% in LTR group, whereas it was 65% in PIT group at 6-month follow-up, which was statistically significant ( P < .05). Pain scores were higher until 5 days in PIT group compared to LTR group ( P = .0001). Intraoperative bleeding mean scores (milliliters) were 8.03 in LTR group compared to 23.29 in PIT group ( P = .00001). Rapidity of healing was faster in LTR group with mean scores of 3.03 weeks in comparison to PIT group where it was 6.33 weeks ( P = .00001). Compared to the conventional technique, the outcomes were better with diode laser and caused less morbidity.

Understanding submucosal electrosurgery for the treatment of nasal turbinate enlargement

2006 ◽  
Vol 121 (7) ◽  
pp. 615-622 ◽  
Author(s):  
S E J Farmer ◽  
R Eccles
Keyword(s):  
Clinical Trials ◽  
Surgical Management ◽  
Inferior Turbinate ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Nasal Turbinate ◽  
History Of ◽  
Turbinate Reduction ◽  
Tissue Reduction ◽  
Made In

The surgical management of inferior turbinate enlargement is controversial. Submucosal electrosurgical techniques for turbinate reduction include conventional diathermy, radiofrequency tissue reduction and coblation. All electrosurgical techniques use radiofrequency electricity to damage turbinate tissue but differ in the control and delivery of energy. This review will examine the history of submucosal electrosurgery and clarify the various techniques. This review will also examine the evidence for the efficacy and safety of electrosurgery for the treatment of nasal turbinate enlargement, and will make a case that no progress will be made in clinical trials on the safety and efficacy unless there is standardisation of equipment and techniques in nasal electrosurgery.

Sign in / Sign up

Export Citation Format

Share Document