title: Sialodochoplasty Stents: Cost Analysis and Outcomes.
abstract: OBJECTIVE
  We reviewed a patient cohort receiving sialodochoplasty with or without salivary stent placement. We propose the Firlit-Kluge pediatric urinary catheter (Cook Medical, Bloomington, IN) as an advantageous alternative stent because of our duct patency results with stenting, considering the advantages and disadvantages of specific stents. We also provide a simple cost summary of commonly used stents.
  
  
  METHODS
  A retrospective review of a case series of patients undergoing sialodochoplasty or salivary duct surgery from 2012 to 2015 was undertaken at a tertiary care center. The indications, duct reconstruction results, and complications were analyzed, and a comparative cost analysis was performed.
  
  
  RESULTS
  Of 25 patients, 16 were stented with Firlit-Kluge catheters, 2 with CORFLO ULTRA feeding tubes (Corpak Medsystems, Buffalo, NY), 1 with an Introcan Safety intravenous (IV) catheter (B. Braun Medical Inc, Melsungen, Germany), and 6 were not stented. All 16 Firlit-Kluge-stented patients had successful duct reconstruction with a patent duct orifice draining saliva on the last follow-up visit, and only 1 stent dislodged early. All patients stented with feeding tubes or the IV catheter experienced discomfort or early dislodgement of the stent. Comparing the Firlit-Kluge stent to commercially available salivary stents, the cost savings in the Firlit-Kluge stent group was $2,480.16 compared with the cost of the Walvekar and Schaitkin stents (Hood Laboratories, Pembroke, MA) and $880.15 to $1,120.00 compared with Ad-Tech-Med stents (Lublin, Poland). However, the cost of the Firlit-Kluge stent exceeded the costs of the Braun IV catheter, Bard infant urinary catheter (Bard Medical Division, CR Bard, Louisville, CO), and CORFLO ULTRA stent by $60.48, $24.64, and $258.72, respectively.
  
  
  CONCLUSIONS
  The Firlit-Kluge urinary catheter incurs considerable cost savings compared with commercial stents, and its silicone makeup and ball flange enhances comfort and prevents dislodgment by aiding in suture placement.
authors.affiliation: Resident, Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA. Electronic address: phan@llu.edu.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Han
authors.affiliation: Medical Student, Loma Linda University School of Medicine, Loma Linda, CA.
authors.forename: Yohanan
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Medical Student, Loma Linda University School of Medicine, Loma Linda, CA.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Yoo
authors.affiliation: Department Vice Chairman, Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA.
authors.forename: Steve
authors.initials: S
authors.lastname: Lee
authors.affiliation: Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA.
authors.forename: Jared C
authors.initials: JC
authors.lastname: Inman
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000601:surgery; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D018987:Salivary Ducts / Q000601:surgery*; D015607:Stents / Q000191:economics*; D016896:Treatment Outcome