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Economic viability of stapes surgery in Germany

Published online by Cambridge University Press:  02 September 2008

E Savvas*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Katholisches Klinikum Marienhof, Koblenz, Germany
J Maurer
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Katholisches Klinikum Marienhof, Koblenz, Germany
*
Address for correspondence: Dr med Eleftherios Savvas, Department of Otolaryngology, Head and Neck Surgery, Katholisches Klinikum Marienhof, Rudolf-Virchow-Strasse 7, 56073 Koblenz, Germany. Fax: 00 49 2614963119 E-mail: [email protected]

Abstract

Objective:

The purpose of this study was to determine the economic viability of stapes surgery in Germany. We compared the cost of the operation to the retail value and average cost of a lifelong supply of hearing aids.

Study design:

Retrospective study.

Setting:

Tertiary referral centre.

Patients:

One hundred and sixty-four consecutive cases of primary stapedotomy performed on patients with otosclerosis at our institution served as the representative group for the calculation. The post-operative air–bone gap average at the frequencies 500, 1000, 2000 and 4000 Hz was less than 10 dB for 62 per cent of the patients, and less than 20 dB for 92 per cent of the patients. There was a post-operative sensorineural hearing loss in 1.2 per cent of the patients.

Results:

Analysis showed that, even for an elderly patient aged 65 years with a life expectancy of 15 years, the cost of a lifelong supply of hearing aids was greater than that of a stapedotomy procedure. Based on our group of patients, the stapedotomy procedure proved to be €800000 K cheaper than treatment with an averagely priced hearing aid. The economic benefit was still present when taking into account possible revision surgery in 5–10 per cent of cases, and also when, in addition to the surgery, a post-operative hearing aid was required, in for example 20 per cent of cases.

Conclusion:

Stapes surgery is economically beneficial for the individual patient as well as for the general patient cohort, irrespective of age. The stapedotomy procedure also prevents the known disadvantages of conventional hearing aids, thus improving the patient's quality of life.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Haeusler, R. General history of stapedectomy. Adv Otorhinolaryngol 2007;65:15Google Scholar
2 Spandow, O, Söderberg, O, Bohlin, L. Long-term results in otosclerotic patients operated by stapedectomy or stapedotomy. Scand Audiol 2000;29:186–90CrossRefGoogle ScholarPubMed
3 House, HP, Hansen, MR, Al Dakhail, AA, House, JW. Stapedectomy versus stapedotomy: comparison of results with long-term follow-up. Laryngoscope 2002;112:2046–50CrossRefGoogle ScholarPubMed
4 Esquivel, CR, Mamikoglu, B, Wiet, RJ. Long-term results of small fenestra stapedectomy compared with large fenestra technique. Laryngoscope 2002;112:1338–41CrossRefGoogle ScholarPubMed
5 Based on reporting from the Federation of Hearing Aid Acoustics [Bundesinnung der Hörgerätakustiker]. [January 2006], http://www.biha.de/modules.php?op=modload&name=Archive&file=index&year=2006&month=01&order=descGoogle Scholar
6 Aarnisalo, AA, Vasama, JP, Hopsu, E, Ramsey, H. Long-term hearing results after stapes surgery: a 20-year follow up. Otol Neurotol 2003;24:567–71CrossRefGoogle ScholarPubMed
7 Kürsten, R, Schneider, B, Zrunek, M. Long-term results after stapedectomy vs. stapedotomy. Am J Otol 1994;15:804–6Google Scholar
8 Klask, J, Schmelzer, A. Postoperative complications of stapes surgery. An analysis of medical and economic aspects [in Germany]. HNO 2003;51:893–7CrossRefGoogle ScholarPubMed
9 Karhuketto, TL, Lundmark, J, Vanhatalo, J, Rautiainen, M, Sipila, M. Stapes surgery: a 32-year follow-up. ORL J Otorhinolaryngol Relat Spec 2007;69:322–6CrossRefGoogle Scholar