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Related Experiment Video

Updated: May 8, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

How Expensive is ENT Surgeons' Involvement in Retrosigmoid Craniotomies? A Time-Driven Activity-Based Cost Analysis.

Danyal A Quraishi1,2, D Mitchell Self1, Steven Glener1

  • 1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, United States.

Journal of Neurological Surgery. Part B, Skull Base
|May 7, 2026
PubMed
Summary

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This summary is machine-generated.

Including ear, nose, and throat (ENT) surgeons in retrosigmoid craniotomies significantly increases operating room costs and time. Routine ENT involvement may not be cost-effective despite potential benefits in specific cases.

Area of Science:

  • Neurosurgery
  • Health Economics
  • Surgical Cost Analysis

Background:

  • Retrosigmoid craniotomy is a complex neurosurgical procedure.
  • The involvement of multiple surgical specialties can impact procedural costs and efficiency.
  • Understanding the cost drivers of multidisciplinary surgical approaches is crucial for resource allocation.

Purpose of the Study:

  • To evaluate the impact of ear, nose, and throat (ENT) surgeon involvement on intraoperative costs and operating room (OR) times for retrosigmoid craniotomies.
  • To determine the cost-effectiveness of routine ENT collaboration in these procedures using time-driven activity-based costing (TDABC).

Main Methods:

  • Retrospective, single-center analysis of 255 retrosigmoid craniotomies (2017-2022).
  • Time-driven activity-based costing (TDABC) methodology was employed to calculate total intraoperative costs.
Keywords:
ENT collaborationcost-effectivenessretrosigmoid craniotomytime-driven activity-based costing

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Last Updated: May 8, 2026

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Published on: August 11, 2015

  • Multiple linear regression analysis assessed the independent effect of ENT surgeon involvement on costs and OR time.

    • Main Results:

    • ENT surgeon involvement was significantly associated with increased total costs (+$4,082) and OR time (+135 minutes).
    • Mean total cost for neurosurgery-only cases was $7,538, compared to $14,217 for cases with ENT involvement.
    • Personnel costs were the primary driver of increased costs; supply costs did not differ significantly.

    Conclusions:

    • Routine ENT surgeon collaboration in retrosigmoid craniotomies is associated with significantly higher intraoperative costs and longer OR times.
    • While beneficial for specific indications (e.g., vestibular schwannomas), routine multidisciplinary involvement may not be cost-effective.
    • Further research integrating outcomes with costs is needed to establish the true value of cross-specialty collaboration.