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Tracheostomy versus mandibular distraction osteogenesis in Canadian children with Pierre Robin sequence: a
Paul Hong1, Michael Bezuhly, S Mark Taylor
1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada. Paul.Hong@iwk.nshealth.ca
Summary
Mandibular distraction osteogenesis (MDO) is a more cost-effective initial treatment for severe newborn airway obstruction due to Pierre Robin sequence (PRS) compared to tracheostomy. This study found MDO to be significantly less expensive than tracheostomy in Canadian healthcare costs.
Area of Science:
- Craniofacial surgery
- Pediatric surgery
- Health economics
Background:
- Newborns with Pierre Robin sequence (PRS) often experience severe upper airway obstruction.
- Tracheostomy is a traditional surgical intervention, while mandibular distraction osteogenesis (MDO) is an effective alternative.
- A comparative cost analysis of these procedures in Canada was lacking.
Purpose of the Study:
- To conduct the first comparative cost analysis between tracheostomy and MDO in Canada for PRS patients.
- To determine the per-patient cost-effectiveness of each surgical modality.
Main Methods:
- A retrospective review of PRS patients who underwent tracheostomy or MDO between 2005 and 2010.
- Detailed cost breakdown of surgical components, healthcare professional fees, and hospital stays for each procedure.
- Statistical comparison of average per-patient costs between the two groups.
Main Results:
- The average per-patient cost was $57,648.55 for MDO and $92,164.45 for tracheostomy.
- Tracheostomy costs were significantly driven by prolonged hospital stays ($72,827.85).
- The average per-patient cost for tracheostomy was 1.6 times greater than for MDO (p = .039).
Conclusions:
- Mandibular distraction osteogenesis (MDO) presents a lower initial cost compared to tracheostomy for treating severe upper airway obstruction in newborns with Pierre Robin sequence (PRS).
- Further prospective studies are needed to evaluate long-term healthcare costs associated with both procedures.
