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1997 and 2000

Wayne J. Harsha, MD; Jonathan A. Perkins, DO; Charlotte W. Lewis, MD, MPH; Scott C. Manning, MD

Arch Otolaryngol Head Neck Surg. 2005;131:564-570.

Objectives  To characterize children undergoing parathyroid, thyroid, and thyroglossal duct cyst surgery in 1997 and 2000 using a nationally representative discharge database to determine whether rates and outcomes of these surgical treatments vary by age, sex, and health care system attributes.

Data Source  The 1997 and 2000 Kids’ Inpatient Database, available through the Agency for Healthcare Research and Quality.

Study Selection  All patients 18 years and younger undergoing head and neck endocrine (HNE) procedures were included.

Data Extraction  The sampling scheme of this database allowed for calculation of national and regional estimates using Stata 7.0.

Data Synthesis  An estimated 2077 and 1871 inpatient pediatric HNE procedures were performed nationally in 1997 and 2000, respectively. Most were performed at general (nonpediatric) teaching hospitals. There were an estimated 1102 thyroglossal duct cyst excisions, making this the most common HNE procedure and diagnosis. Thyroid lobectomy was the second most common HNE surgical treatment. Thyroid malignant neoplasm (usually treated by total thyroidectomy) was the second most common diagnosis. Neck dissections were performed in 32% of patients with thyroid malignant neoplasm. These HNE procedures accounted for more than $28 million in hospital charges in 1997 and nearly $38 million in 2000.

Conclusions  Surgical treatment trends for pediatric HNE procedures remained stable between 1997 and 2000. Thyroglossal duct cyst excision and thyroid lobectomy are the most common procedures. There were regional differences in the rates of most HNE surgical treatments. In addition, hospital charges increased between 1997 and 2000.

Author Affiliations: Otolaryngology Service, Madigan Army Medical Center, Tacoma (Dr Harsha); Division of Pediatric Otolaryngology (Drs Perkins and Manning) and Craniofacial Center (Drs Perkins and Lewis), Children’s Hospital and Regional Medical Center, Seattle; and Departments of Otolaryngology–Head and Neck Surgery (Drs Perkins and Manning) and Pediatrics (Dr Lewis) and Child Health Institute (Dr Lewis), University of Washington, Seattle.

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