Analysis of cost and outcomes in bony versus soft tissue midface free flap reconstruction
Corresponding Author
Angela Alnemri MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Correspondence
Angela Alnemri, Department of Otolaryngology – Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut Street, 6th floor, Philadelphia, PA 19107, USA.
Email: [email protected]
Search for more papers by this authorRamez Philips MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorSarah Sussman MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorVivian Xu MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAlyssa Givens MD
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAnjali Patel BS
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorBrian Swendseid MD
Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
Search for more papers by this authorAarti Agarwal MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorScott Keith PhD
Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAyako Shimada MS
Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorYamil Selman MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorDavid M. Cognetti MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRyan Heffelfinger MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRichard Goldman MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAdam J. Luginbuhl MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMark K. Wax MD
Department of Otolaryngology – Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
Search for more papers by this authorLarissa Sweeny MD
Department of Otolaryngology – Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
Search for more papers by this authorJoseph M. Curry MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
Angela Alnemri MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Correspondence
Angela Alnemri, Department of Otolaryngology – Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut Street, 6th floor, Philadelphia, PA 19107, USA.
Email: [email protected]
Search for more papers by this authorRamez Philips MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorSarah Sussman MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorVivian Xu MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAlyssa Givens MD
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAnjali Patel BS
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorBrian Swendseid MD
Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
Search for more papers by this authorAarti Agarwal MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorScott Keith PhD
Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAyako Shimada MS
Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorYamil Selman MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorDavid M. Cognetti MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRyan Heffelfinger MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorRichard Goldman MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAdam J. Luginbuhl MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMark K. Wax MD
Department of Otolaryngology – Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
Search for more papers by this authorLarissa Sweeny MD
Department of Otolaryngology – Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
Search for more papers by this authorJoseph M. Curry MD
Department of Otolaryngology – Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorPoster presentation at the American Head and Neck Society 10th International Conference on Head and Neck Cancer “Survivorship through Quality and Innovation,” 22–25 July 2021.
Abstract
Background
Outcomes and cost of soft tissue versus bony midface free flap reconstruction (MR) with and without virtual surgical planning (VSP) were evaluated.
Methods
Retrospective review of MR including ischemic time (IT), operative duration (OD), length of stay (LOS), and total cost (TC). Eighty-one soft tissue and 76 bony MR (VSP = 23) were reviewed.
Results
Bony MR was used for higher complexity defects (p = 0.003) and was associated with higher IT (p < 0.001), OD (p < 0.001), LOS (p = 0.032), and TC (p < 0.001). VSP was associated with a mean 111.2 ± 37.9 minute reduction in OD (p = 0.004) compared to non-VSP bony flaps. VSP was associated with higher itemized cost, but no increase in TC (p = 0.327).
Conclusions
Bony MR was used for higher complexity MR and was associated with increased TC, LOS, OD, and IT. VSP shortened OD with no significant increase in TC.
CONFLICT OF INTEREST
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| hed27112-SUP-0001-Tables.pdfPDF document, 65 KB | Table S1 Breakdown of Cost Categories by UB Revenue Codes. Table S2 Descriptive statistics summary of total cost by Brown & Shaw classification, n = 157. Table S3 Descriptive statistics summary of total cost by Santamaria & Cordeiro classification, n = 157. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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