Conclusions:
This study demonstrates a direct cost saving of £1463.22 per case of cholesteatoma managed endoscopically. This figure may under-represent the total cost savings for the patient and the healthcare system as a whole. This work adds to the building armamentarium of evidence on the economic advantage of endoscopic ear surgery over a microscopic approach, and may be helpful to key policy stakeholders and hospitals in performing a Health Technology Assessment of the endoscopic approach to ear surgery.