{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:57:32Z","timestamp":1789649852369,"version":"4.0.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T00:00:00Z","timestamp":1543276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Laryngotracheal stenosis (LTS) is resource\u2010intensive disease. The cost\u2010effectiveness of LTS treatments has not been adequately explored. We aimed to conduct a cost\u2010effectiveness analysis comparing open reconstruction (cricotracheal\/tracheal resection [CTR\/TR]) with endoscopic dilation in the treatment of LTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral center (2013\u20102017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Thirty\u2010four LTS patients were recruited. Annual costs were derived from the Department of Otolaryngology\u2013Head and Neck Surgery, Johns Hopkins University. Cost\u2010effectiveness analysis compared CTR\/TR versus endoscopic dilation at a willingness\u2010to\u2010pay threshold of $50,000 per quality\u2010adjusted life year (QALY) over 5\u2010 and 10\u2010year time horizons. The incremental cost\u2010effectiveness ratio (ICER) was calculated with deterministic analysis and tested for sensitivity with univariate and probabilistic sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean LTS costs were $4080.09 (SE, $569.29) annually for related health care visits. The major risk factor for increased cost was etiology of stenosis. As compared with idiopathic patients, patients with intubation\u2010related stenosis had significantly higher annual costs ($5286.56 vs $2873.62, <jats:italic>P<\/jats:italic> =. 03). The cost of CTR\/TR was $8583.91 (SE, $2263.22). Over a 5\u2010year time horizon, CTR\/TR gained $896 per QALY over serial dilations and was cost\u2010effective. Over a 10\u2010year time horizon, CTR\/TR dominated dilations with a lower cost and higher QALY.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The cost of treatment for LTS is significant. Patients with intubation\u2010related stenosis have significantly higher annual costs than do idiopathic patients. CTR\/TR contributes significantly to cost in LTS but is cost\u2010effective versus endoscopic dilations for appropriately selected patients over a 5\u2010 and 10\u2010year horizon.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818815068","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T15:09:37Z","timestamp":1543331377000},"page":"679-686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Health Care Costs and Cost\u2010effectiveness in Laryngotracheal Stenosis"],"prefix":"10.1002","volume":"160","author":[{"given":"Linda X.","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology School of Graduate Medical Education Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William V.","family":"Padula","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management 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