Benchmarks for the durations of ambulatory surgical procedures in otolaryngology.
OBJECTIVE
I undertook to determine benchmarks and variability for the surgical times associated with ambulatory otolaryngological procedures in the United States.


METHODS
I examined the 2006 release of the National Survey of Ambulatory Surgery and extracted all cases of otolaryngological surgery in which one, and only one, otolaryngological procedure was performed. The mean surgical times and operating room times were determined for each procedure that met reliability criteria for their estimates. A secondary analysis was computed for tonsillectomy and for tonsillectomy plus adenoidectomy according to a patient age of greater than 12 years.


RESULTS
An estimated 1.68 +/- 0.23 million otolaryngological procedures were analyzed as solitary procedures, including 507,000 cases of myringotomy with ventilation tube placement, 136,000 cases of tonsillectomy, and 429,000 cases of tonsillectomy plus adenoidectomy. The mean (+/- SE) surgical times were 8.0 +/- 0.5, 23.9 +/- 1.8, and 20.3 +/- 0.8 minutes, respectively. The total operating room times were 17.6 +/- 0.9, 48.2 +/- 2.0, and 40.7 +/- 1.1 minutes, respectively. Septoplasty with turbinectomy was the most common rhinologic procedure performed (48,000 cases analyzed) and had surgical and operating room times of 49.6 +/- 4.78 and 79.8 +/- 5.8 minutes, respectively. The surgical times for tonsillectomy and tonsillectomy plus adenoidectomy did not differ significantly in magnitude according to standard age cutoffs, although the operating room time was slightly (11.7 minutes) longer for tonsillectomy in patients more than 12 years of age (p = 0.034).


CONCLUSIONS
The surgical times for the performance of the most common otolaryngological ambulatory procedures are remarkably consistent in the United States. Given the volume and consistency of these surgical procedures, they are ideal candidates for studies of cost and efficiency.
Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Neil
N
Bhattacharyya
D000233:Adenoidectomy / Q000592:standards; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000556:Ambulatory Surgical Procedures / Q000592:standards; D019985:Benchmarking; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009225:Myringoplasty / Q000592:standards; D010036:Otolaryngology / Q000592:standards; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000592:standards; D010045:Outpatients; D013997:Time Factors; D014068:Tonsillectomy / Q000592:standards; D016896:Treatment Outcome; D014481:United States