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Medialization thyroplasty versus injection laryngoplasty: a cost minimization analysis
Samantha Tam1, Hongmei Sun2, Sisira Sarma3
1Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Summary
Injection laryngoplasty offers significant cost savings for unilateral vocal fold paralysis compared to medialization thyroplasty. This procedure is a cost-effective alternative, saving over $1500 per patient.
Area of Science:
- Otolaryngology
- Health Economics
- Medical Decision Making
Background:
- Unilateral vocal fold paralysis is commonly treated with medialization thyroplasty or injection laryngoplasty.
- Both procedures offer similar clinical outcomes but have different cost profiles.
- Medialization thyroplasty incurs higher operating room costs, while injection laryngoplasty may require repeat procedures.
Purpose of the Study:
- To quantify the cost differences between medialization thyroplasty and injection laryngoplasty for unilateral vocal fold paralysis.
Main Methods:
- A cost minimization analysis was performed using a decision tree model.
- Data on clinical scenarios and event probabilities were sourced from a retrospective cohort at London Health Sciences Centre.
- Costs were analyzed from a Canadian academic hospital perspective over a 5-year time horizon, using 2014 Canadian dollars.
Main Results:
- Medialization thyroplasty cost C$2499.10 per patient, while injection laryngoplasty cost C$943.19 per patient.
- Injection laryngoplasty resulted in cost savings of C$1555.91 per patient.
- Sensitivity analyses indicated potential cost savings ranging from C$596 to C$3626.
Conclusions:
- Injection laryngoplasty is a more cost-effective treatment option for unilateral vocal fold paralysis.
- The procedure offers substantial cost savings compared to medialization thyroplasty.
- Given similar effectiveness and significant cost benefits, injection laryngoplasty should be strongly considered.
