J Neurol Surg B 2015; 76(01): 039-042
DOI: 10.1055/s-0034-1390019
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Costs of Skull Base Surgery in the Pediatric Population

A. L. Stapleton1, E. C. Tyler-Kabara2, P. A. Gardner2, C. H. Snyderman1, 2
  • 1Department of Otolaryngology, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
  • 2Department of Neurological Surgery, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
Further Information

Publication History

09 April 2014

16 June 2014

Publication Date:
13 September 2014 (eFirst)

Abstract

Objectives To determine the costs of endoscopic endonasal surgery (EES) for pediatric skull base lesions.

Methods Retrospective chart review of pediatric patients (ages 1 month to 19 years) treated for skull base lesions with EES from 1999 to 2013. Demographic and operative data were recorded. The cost of care for the surgical day, intensive care unit (ICU), floor, and total overall cost of inpatient stay were acquired from the finance department.

Results A total of 160 pediatric patients undergoing EES for skull base lesions were identified. Of these, 55 patients had complete financial data available. The average total inpatient and surgical costs of care were $34, 056 per patient. Angiofibromas were the most costly: $59,051 per patient. Fibro-osseous lesions had the lowest costs: $10,931 per patient. The average ICU stay was 1.8 days at $4,577 per ICU day. The average acute care stay was 3.4 days at $1,961 per day. Overall length of stay was 4.5 days. Three cerebrospinal fluid leaks (4%) and two cases of meningitis (3%) occurred. One tracheostomy was required (1.5%).

Conclusions EES is a cost-effective model for removal of skull base lesions in the pediatric population. Costs of care vary according to pathology, staged surgeries, length of ICU stay, and need for second operations.