Systemic Effects of Subcutaneous Heparin Use in Otolaryngology Patients

Abstract

Unanticipated systemic effects of subcutaneous low-dose unfractionated heparin can cause significant morbidity in surgically treated patients with head and neck cancer. From this case series, risk factors appear to include subcutaneous low-dose unfractionated heparin 3 times daily dose frequency, low body mass index, and renal dysfunction. For this at-risk patient population, a protocol is needed to minimize both deep vein thromboses and complications of prophylactic therapy.

Cochlear Implantation in the Setting of Perioperative Anticoagulation and Antiplatelet Therapy

“…Blank et al found that rates of postoperative hemorrhage in patients undergoing ablative head and neck cancer surgery were higher in the setting of low-dose unfractionated heparin use. 3 Francis et al recently reviewed a laryngeal surgeon's 2-year operative experience and found that maintaining patients on anticoagulation led to no change in perioperative complications after microlaryngeal surgery. 4 To date, perioperative anticoagulation management in patients undergoing cochlear implantation remains understudied.…”

“…Few studies have investigated the effects of anticoagulation and antiplatelet therapy on head and neck surgical outcomes. Blank et al found that rates of postoperative hemorrhage in patients undergoing ablative head and neck cancer surgery were higher in the setting of low‐dose unfractionated heparin use 3 . Francis et al recently reviewed a laryngeal surgeon’s 2‐year operative experience and found that maintaining patients on anticoagulation led to no change in perioperative complications after microlaryngeal surgery 4 …”