Abstract
PurposeTo analyse costs related to the diagnosis and treatment of patients with sialolithiasis and sialadenitis managed with sialendoscopy, and to prospectively evaluate the impact of sialendoscopy on health-related quality of life (HRQoL) in a longitudinal follow-up study.MethodsAll patients undergoing sialendoscopy or sialendoscopy-assisted surgery at a tertiary care university hospital between January 2014 and May 2016 were identified from a surgical database, and the direct hospital costs were retrospectively evaluated from 1 year before to 1 year after the sialendoscopy. The 15D HRQoL questionnaire and a questionnaire exploring the use of health care services during the preceding 3 months were mailed to the patients before sialendoscopy as well as at 3 and 12 months after the operation.ResultsA total of 260 patients were identified. Mean total hospital costs, costs related to the sialendoscopy, and complications were significantly higher in sialolithiasis patients than in patients with other diagnoses. 74 patients returned the baseline 15D questionnaire, and 51 patients all three 15D questionnaires. At baseline, the dimensions “discomfort and symptoms” and “distress” were lower in patients than in age- and gender-standardised general population, but the total 15D score did not differ significantly. The dimension “discomfort and symptoms” improved significantly at 3 and 12 months postoperatively, and the mean total HRQoL score improved in patients with sialolithiasis at 3 months postoperatively.ConclusionsThe costs related to sialendoscopy are substantial and the cost-effectiveness of sialendoscopy warrants further studies. However, sialendoscopy seems to reduce patients’ discomfort and ailments and to improve HRQoL at least in patients with sialolithiasis.
Highlights
The development of sialendoscopy has offered a minimally invasive alternative to diagnose and treat obstructive sialadenitis
This study investigated the costs of treatment of sialadenitis patients managed with sialendoscopy and measured the effect of sialendoscopy on patients’ health-related quality of life (HRQoL) using the generic 15D questionnaire at a tertiary care academic hospital
Both the mean total hospital costs and the mean sialendoscopy costs were higher in patients with sialolithiasis, while the mean costs of clinical encounters were higher in patients without sialoliths
Summary
The development of sialendoscopy has offered a minimally invasive alternative to diagnose and treat obstructive sialadenitis. The most common symptom of obstructive sialadenitis is recurrent, usually painful swelling of the salivary gland during meals, while chronic inflammatory disorders such as Sjögren’s syndrome, chronic recurrent parotitis, and juvenile parotitis are more often characterized by intermittent, mildly tender swelling of the gland(s) that sometimes persists for days [7, 8]. Both disorders may be complicated by bacterial infections [8]. While the therapeutic benefits of sialendoscopy have been demonstrated in many studies and reviews
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