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ENT management of patients with coagulation disorders.

In patients with untreated coagulation disorders

  • Epistaxis is a potentially life-threatening event:
    - If artificial ventilation is required.
    - If blood enters the lower respiratory system
  • Post-tonsillectomy bleeding requiring treatment is
    10 times more likely in carriers of hemophilia A or B than in non-carriers.12

Management

  • Neoplasia should be ruled out as the cause of
    recurrent epistaxis or tonsil hemorrhaging.36, 39
  • Before surgery, the activity of the deficient
    coagulation factor should be measured and
    adequate levels should be ensured.
  • After surgery, close follow-up is recommended, to
    monitor coagulation factor levels, and to assess
    for delayed bleeding complications.15
If you suspect a coagulation disorder, investigate the patient’s bleeding history.


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