Airway obstruction secondary to bleeding from warfarin therapy is difficult to manage and uncommon but has been previously described. Previous reports have emphasized the need for reversal of therapy using vitamin K and fresh frozen plasma (FFP). Where a definitive airway has been required, cricothyroidotomy or tracheostomy seem to have been favoured. Several authors have reported failed attempts at endotracheal intubation due to the obstructive effects of a sublingual haematoma. We report here a case which illustrates how endotracheal intubation can be used successfully under the right conditions. It also highlights the superiority of prothrombin complex concentrate over FFP in achieving rapid reversal of abnormal international normalized ratio in the emergency situation.

There is no evidence from this study to support frequent endoscopic cleaning in the early post-operative period after functional endoscopic sinus surgery. Less intensive post-operative management is recommended, resulting in decreased patient morbidity and fewer post-operative follow-up appointments.

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