title: Cost savings of unsedated office-based laser surgery for laryngeal papillomas.
abstract: OBJECTIVE
  Unsedated office-based laryngeal laser surgery (UOLS) is now an effective alternative to traditional operating room-based suspension microdirect laryngoscopy under general anesthesia. This procedure includes pulsed dye laser (PDL) treatment of recurrent respiratory papillomas, granulomas, leukoplakia, and polypoid degeneration. The objective of this study was to determine the magnitude of the cost savings derived by moving these types of procedures from the operating room to the office setting.
  
  
  METHODS
  Retrospective cost-identification analysis was performed by comparing the billing records of patients who underwent surgical laser treatment for recurrent respiratory papillomatosis in the operating room to the costs and charges for patients who underwent similar procedures with the in-office PDL.
  
  
  RESULTS
  In performing surgery with the PDL in the office, the average cost savings was more than $5,000 per case. Current reimbursement rates do not cover the cost of performing UOLS.
  
  
  CONCLUSIONS
  The potential cost savings of UOLS are tremendous; however, at present significant financial disincentives prevent proliferation of this technology.
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Rees
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Postma
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Koufman
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D017046:Cost Savings; D006801:Humans; D007822:Laryngeal Neoplasms / Q000191:economics / Q000601:surgery*; D053685:Laser Therapy / Q000191:economics*; D008875:Middle Aged; D009657:North Carolina; D009873:Operating Rooms; D010212:Papilloma / Q000191:economics / Q000601:surgery*; D010824:Physicians' Offices; D012008:Recurrence; D012189:Retrospective Studies