Day-case otologic surgery: Stapes surgery & cochlear implantation

Abstract

In this thesis the feasibility, safety, and costs of performing ear surgery in a day-case setting, compared to inpatient admission, was investigated. The focus was particularly on stapes surgery and cochlear implantation, with data derived from two randomized controlled trials. We found no difference in postoperative hearing outcomes, patient quality of life, patient satisfaction, and safety in terms of postoperative complications and readmissions between the day-case and inpatient group. The financial advantage of a day-case setting was not evident from our research, partly due to the large number of day-case patients requiring postoperative inpatient admission. However, it is probable that the costs of a day-case admission are lower than that of inpatient admission. For the discussion, we evaluated ear surgeries performed during the COVID-19 pandemic. We found that patients operated on in a Day Surgery Center, where both the patient and the involved personnel had a day-case mindset, had a much higher success rate for surgery actually being performed in a day-case setting. In conclusion, day-case otologic surgery appears feasible and safe for major ear surgery. This requires careful patient selection, surgical planning, and a "day-case mentality" among all involved parties.