Type 1 Thyroplasty as an Outpatient Surgery: Safety and Cost Effectiveness

Abstract

Objectives:

Determine the safety and cost effectiveness of type 1 thyroplasty as outpatient surgery without a surgical drain or post-anesthesia care unit (PACU) observation. Study Design: Prospective cohort study.

Methods:

Patients with vocal cord immobility (n = 25) were surgically managed with an outpatient type 1 thyroplasty under conscious sedation without a surgical site drain from April 1, 2013, through October 1, 2013. Eighteen of 25 patients were transported directly from the operating room to the nursing unit, completely avoiding the PACU. Historical inpatient controls (n = 25) were included for comparison. Postoperative complications were recorded. A cost analysis was conducted to compare inpatient versus outpatient surgery.

Results:

In our series of patients undergoing outpatient type 1 thyroplasty, only 1 of 25 (4.0%) postoperative hematoma was documented. No postoperative complications occurred in the inpatient control group. Outpatient type 1 thyroplasty cost $922 less than overnight surgery. Avoiding the PACU resulted in an additional $550 savings.

Conclusions:

Our prospective study demonstrated that outpatient type 1 thyroplasty without a surgical drain is a safe and cost-effective surgery in appropriately selected patients. Furthermore, doing the surgery under light sedation allows the patient to be transported directly to the nursing unit, avoiding the additional cost of the post-anesthesia care unit.