Mandloi Shreya, Garg Neha, Naimi Bita, Shah Riya, Kaki Praneet, Alnemri Angela, Duffy Alexander, Zhan Tingting, Kaffenberger Thomas M, Boon Maurits S, Huntley Colin T
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.
Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
Laryngoscope. 2025 Jan;135(1):457-462. doi: 10.1002/lary.31697. Epub 2024 Aug 13.
Transoral robotic surgery (TORS) lingual tonsillectomy and hypoglossal nerve stimulation (HGNS) are effective surgical interventions for well-selected patients with obstructive sleep apnea (OSA) intolerant to continuous positive airway pressure (CPAP) therapy. Previous publications have demonstrated that HGNS patients have a lower postoperative apnea-hypopnea index (AHI) and length of hospital stay than TORS patients. No prior study has investigated the differences in costs between HGNS and TORS.
This study aims to compare surgery-related costs in patients undergoing HGNS versus TORS lingual tonsillectomy for OSA intolerant to CPAP.
A retrospective study on OSA patients intolerant to CPAP that underwent HGNS or TORS from 2015 to 2022 at a tertiary care center. Cost was defined as the dollar amount associated with providing a specific service prior to the application of insurance.
This study included 395 patients (375 UAS and 20 TORS). Average total cost was significantly higher in the UAS group than the TORS group (UAS: $25,582.60; TORS: $5832.60; p < 0.001). Operating room costs were also significantly higher in the UAS group (UAS: $1978.20; TORS: $1490.90; p = 0.001). The TORS cohort averaged higher costs for pharmacy (UAS: $201.30; TORS: $416.60; p < 0.001) and anesthesia (UAS: $139.00; TORS: $307.60; p < 0.001).
The total cost was significantly higher in the UAS group compared to the TORS group. When making management decisions, it is important to consider the cost of care provided as well as patient-centered outcomes to optimize the value of care.
NA Laryngoscope, 135:457-462, 2025.
经口机器人手术（TORS）舌扁桃体切除术和舌下神经刺激术（HGNS）是针对选择恰当的、不耐受持续气道正压通气（CPAP）治疗的阻塞性睡眠呼吸暂停（OSA）患者的有效手术干预措施。既往发表的文献表明，与TORS患者相比，HGNS患者术后的呼吸暂停低通气指数（AHI）更低，住院时间更短。此前尚无研究调查HGNS和TORS之间的费用差异。
本研究旨在比较接受HGNS与TORS舌扁桃体切除术治疗的、不耐受CPAP的OSA患者的手术相关费用。
对2015年至2022年在一家三级医疗中心接受HGNS或TORS治疗的不耐受CPAP的OSA患者进行一项回顾性研究。费用定义为在保险应用之前与提供特定服务相关的美元金额。
本研究纳入了395例患者（375例行HGNS和20例行TORS）。HGNS组的平均总费用显著高于TORS组（HGNS组：25582.60美元；TORS组：5832.60美元；p < 0.001）。HGNS组的手术室费用也显著更高（HGNS组：1978.20美元；TORS组：1490.90美元；p = 0.001）。TORS队列的药房费用（HGNS组：201.30美元；TORS组：416.60美元；p < 0.001）和麻醉费用（HGNS组：139.00美元；TORS组：307.60美元；p < 0.001）平均更高。
HGNS组的总费用显著高于TORS组。在做出管理决策时，重要的是要考虑所提供护理的成本以及以患者为中心的结果，以优化护理价值。
NA 《喉镜》，135:457 - 462，2025年。
