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Evolution and safety of day-case major ear surgery
S Bonnafous1, R Hermann2, S Zaouche1
1Service d'otologie et d'otoneurologie, hospices civils de Lyon, centre hospitalier Lyon Sud, université de Lyon, université Claude-Bernard Lyon 1, 69495 Pierre-Bénite, France.
Aims:
To study the evolution of middle-ear surgery in 2019 in relation to the French Health Authority target of 66% day-surgery by 2020.
Material And Methods:
A single-center retrospective observational study included all patients undergoing otologic surgery between January 2014 and December 2018 in a university hospital center. 1064 of the 1368 patients were scheduled for outpatient surgery: 309 for otosclerosis, 355 for tympanoplasty with or without ossiculoplasty, 376 for cholesteatoma and 24 for other procedures. Two groups were constituted: day-surgery and conventional, according to hospital stay. Surgery time, follow-up duration, number of crossovers to conventional admission, number of emergency postoperative consultations, number of readmissions and data from the phone-call systematically made the day after surgery were analyzed. The main objective was to evaluate the safety of outpatient surgery for major middle-ear interventions compared to a control group managed under conventional admission during the same period.
Results:
27 patients (2.5%) required crossover, mainly due to disabling vertigo (57.7%). 53 patients (4.9%) consulted before the scheduled 8th day consultation, because of severe pain (23.5%) or dizziness (34.0%). Only 10 patients required emergency readmission.
Conclusion:
Provided that the inclusion criteria are met, all major middle-ear surgery procedures can be performed as day-surgery under satisfactory safety conditions.
