Costs of sialendoscopy and impact on health-related quality of life

Abstract

PurposeTo analyse costs related to the diagnosis and treatment of patients with sialolithiasis and sialadenitis managed with sialendoscopy, and to prospectively evaluate the impact of sialendoscopy on health-related quality of life (HRQoL) in a longitudinal follow-up study.MethodsAll patients undergoing sialendoscopy or sialendoscopy-assisted surgery at a tertiary care university hospital between January 2014 and May 2016 were identified from a surgical database, and the direct hospital costs were retrospectively evaluated from 1 year before to 1 year after the sialendoscopy. The 15D HRQoL questionnaire and a questionnaire exploring the use of health care services during the preceding 3 months were mailed to the patients before sialendoscopy as well as at 3 and 12 months after the operation.ResultsA total of 260 patients were identified. Mean total hospital costs, costs related to the sialendoscopy, and complications were significantly higher in sialolithiasis patients than in patients with other diagnoses. 74 patients returned the baseline 15D questionnaire, and 51 patients all three 15D questionnaires. At baseline, the dimensions “discomfort and symptoms” and “distress” were lower in patients than in age- and gender-standardised general population, but the total 15D score did not differ significantly. The dimension “discomfort and symptoms” improved significantly at 3 and 12 months postoperatively, and the mean total HRQoL score improved in patients with sialolithiasis at 3 months postoperatively.ConclusionsThe costs related to sialendoscopy are substantial and the cost-effectiveness of sialendoscopy warrants further studies. However, sialendoscopy seems to reduce patients’ discomfort and ailments and to improve HRQoL at least in patients with sialolithiasis.

Sialolithiasis: retrospective analysis of the effect of an escalating treatment algorithm on patient-perceived health-related quality of life

“…The treatment algorithm could significantly ease symptoms. This could also be shown by other studies [ 23 , 34 – 37 ]. 94.3% of patients would want to receive the same therapy again in case of recurrent sialolithiasis which supports improved HRQoL.…”

“…Depending on the type of affected gland therapy follows a minimally-invasive treatment algorithm [ 20 ]. Studies reported improved health-related quality of life (HRQoL) of sialendoscopy despite higher costs [ 23 ]. In the present study we found a male:female ratio of 1:1 which is in line with the findings by Zenk et al (1999) [ 7 ].…”

Success of minimally invasive salivary gland surgery—Quality of life, prognostic factors

“…Very few studies referred to the effect of sialendoscopy on quality of life and rarely with measurement tools specific for salivary gland to Aubin-Pouliot et al, 12 Gillespie et al 13 or Jokela et al, 14 nor a negative effect of inflammatory diseases on quality of life as opposed to Gillespie et al 13 As Gillespie et al demonstrated, 13 no difference in quality of life could be shown in patients with follow-up salivary gland removals and patients with salivary gland preservation. However, this data demonstrates association of any frequent additional conservative or invasive therapies with worse quality of life.…”

Qualität der Therapie von Speicheldrüsenerkrankungen

“…Unlängst wurde der POI-8 in einer deutschen multizentrischen prospektiven chirurgischen Studie zu Langzeitfolgen nach lateraler Parotidektomie eingesetzt [52]. Bei [57]. Zu 74 Patienten gab es auch präoperative Daten, was eine bemerkenswerte Besonderheit darstellt.…”

“…In einer prospektiven finnischen Studie an 270 Patienten, die zwischen 2014 und 2016 eine Sialendoskopie erhielten, waren die höheren Therapiekosten bei Sialolithiasis im Vergleich zu anderen Indikationen mit einem besseren Lebensqualitätsgewinn assoziiert; die Daten wurden aber nicht, wie z. B. zur Berechnung eines qualitätskorrigiertes Lebensjahrs (QALY) ins Verhältnis gesetzt [57]. Besonders kosteneffizient war in einer US-amerikanischen Studie die Sialendoskopie zur Entfernung intraparotidealer Steine bei einem transfazialen Vorgehen, wenn also der Stein über den Stenon-Gang nicht erreichbar ist, und alternativ nur eine Parotidektomie möglich wäre [117].…”