Setting: Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital, Ohio State University Medical Center, Columbus.
Synopsis: Recently, highly respected journals have published articles describing endoscopic surgery for the thyroid via the axilla and the removal of benign neck masses in children using an endoscopic axillo-breast approach. These articles describe procedures with increased operative time, risks, complications and cost compared with standard approaches to the thyroid or neck mass biopsy. With health care often considred to be too costly, it is unclear how procedures such as these will be supported in today’s health care world and in the future. The question is, are these procedures developed in the same way as endoscopic skull base surgery and pituitary surgery, procedures that have completely changed health care for the better in terms of cost, safety, recovery and outcomes?
Bottom line: Perhaps we need to rethink some surgical developments that are more costly, less safe and more prone to complication—especially in cases where standard surgeries have stood the test of time. Meanwhile, it is hoped that surgeons using these procedures to treat patients describe to patients all factors involved, including cost, safety issues and the increased risk of complications.