It's All About the Money, Honey! - A retrospective cost comparison between total endoscopic ear surgery and microscopic surgery for attic cholesteatoma

Introduction and Objectives: Endoscopic ear surgery (EES) is rapidly emerging as a mainstream surgical modality, with recent literature highlighting its advantages over traditional approaches. This study tests the null hypothesis that there is no difference in direct costs of total endoscopic ear surgery and microscopic ear surgery for attic cholesteatoma in a British National Health Service District General Hospital setting. Study Design: Retrospective cost comparison Setting: district general hospital Participants: patients undergoing surgery for cholesteatoma limited to the attic, either via endoscopic or microscopic approach Cost comparison: Direct cost comparison of anaesthetic set up, surgical set up, and surgical time between total endoscopic ear surgery and microscopic ear surgery for attic cholesteatoma. Main outcome measures: Direct costs of anaesthetic set up, surgical set up, and surgical time Results: Total endoscopic ear surgery had a significant cost saving of £1419.01 per operation. Conclusion: Total endoscopic ear surgery is more cost-effective than microscopic surgery for attic cholesteatoma in a British National Health Service District General Hospital setting.