Trend in otolaryngological surgeries in an era of super-aging: Descriptive statistics using a Japanese inpatient database

Publication date: December 2018

Source: Auris Nasus Larynx, Volume 45, Issue 6

Author(s): Sayaka Suzuki, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Tatsuya Yamasoba

Abstract

Objective

To reveal the age distribution and capture the longitudinal trend in otolaryngological surgeries performed in Japan, where society is rapidly aging.

Methods

Using the Diagnosis Procedure Combination database, we extracted data on patients who were hospitalized and underwent any type of otolaryngological surgery in departments of otolaryngology or head and neck surgery from fiscal year 2007 to fiscal year 2013. Type of surgery, patient's age, and fiscal year were compared. We categorized >200 types of surgeries into eight specialties: ear surgery, functional endoscopic sinus surgery (FESS), other types of paranasal surgery (except for malignancy), head and neck cancer surgery, benign tumor surgery, upper airway surgery (including pharynx and larynx), removal of foreign body, and other.

Results

In total, 558,732 patients were included. The proportions of patients in each age category formed two peaks in middle age and in children aged ≤9 years. The proportion of all surgeries made up by FESS, other paranasal surgery, benign tumor surgery, and head and neck cancer surgery gradually increased with age, forming a peak in patients in their 60s. The proportion of ear surgery was highest in patients aged ≤9 years (34.0% of all surgeries, mostly myringotomy and transtympanic ventilation tube insertion) and formed a gradual peak in patients in their 60s (mostly tympanoplasty). The proportion of upper airway surgery (tonsillectomy and adenoidectomy) was highest in patients aged ≤9 years (25.3% of all surgeries). The proportion of foreign body removal was highest in patients aged ≤9 years (52.2% of all surgeries) and increased slightly with age. In 2013, compared with 2007, those aged 65–74 years and ≥75 years made up a larger percentage of patients undergoing each specific surgery, including tympanoplasty, stapedectomy/stapedotomy, FESS, head and neck cancer surgery, pharyngolaryngectomy, total/subtotal glossectomy, thyroid lobectomy, parotidectomy (for a benign tumor), submandibular gland resection, tonsillectomy, and vocal fold polypectomy.

Conclusion

The age distribution of otolaryngological surgeries varied by specialty. We found an increased proportion of patients aged 65–74 and ≥75 years in most specific surgeries.

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