Two cases of peritonsillar abscess complicated by von Willebrand disease

Nagano, Hikaru; Harada, Mizue; Umakoshi, Mizuo; Hayamizu, Yoshiko; Yoshifuku, Kosuke; Kurono, Yuichi

doi:10.1016/j.anl.2011.08.008

Cited by 1 publication

(4 citation statements)

References 6 publications

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“…Warrier and Lusher, 6 Ghirardini et al, 8 Berlucchi et al, 11 Shah et al, 14 and Mannucci et al 15 all describe cohorts of patients with vWD who received DDAVP prophylactically prior to surgery and experienced zero bleeding events. Macksey and White 17 and Nagano et al 18 published case reports in which their single subjects with bleeding disorders were perioperatively treated with DDAVP and subsequently did not experience any postoperative bleeding events. Rodriguez et al 20 performed a retrospective case‐control study and found similar rates of postoperative bleeding in patients with vWD prophylactically treated with DDAVP undergoing T&A and patients without vWD undergoing the same procedures.…”

Section: Resultsmentioning

confidence: 99%

“…In patients without a bleeding disorder, the literature shows that the bleeding risk for adenotonsillectomy is from 1.3% to 5.3% and would be the current ideal goal in patients with bleeding disorders. 19,[27][28][29][30][31] Although many studies in this systematic review claim to have equilibrated to the healthy statistic with a perioperative DDAVP success rate of 100%, 6,8,11,17,18 not all demonstrate this equilibration. Several studies demonstrate a lower perioperative success rate (73%-75%) with regard to adequate bleeding control or prevention of a postoperative bleeding event if the patient has an inherited bleeding disorder while being treated with DDAVP.…”

Section: Discussionmentioning

confidence: 99%

“…There have been many studies documenting perioperative usage of DDAVP in patients with bleeding disorders in the otolaryngologic setting. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Most of these publications are centered on prevention of postoperative bleeding events in patients with inherited bleeding disorders, although several focus on hematologically healthy individuals. 4,21,22 In addition, a smaller number of studies have investigated the efficacy of DDAVP as a treatment for postoperative bleeding after tonsillectomies and adenoidectomies (T&As) and other otolaryngology procedures.…”

mentioning

confidence: 99%

“…There have been many studies documenting perioperative usage of DDAVP in patients with bleeding disorders in the otolaryngologic setting 4‐20 . Most of these publications are centered on prevention of postoperative bleeding events in patients with inherited bleeding disorders, although several focus on hematologically healthy individuals 4,21,22 .…”

mentioning

confidence: 99%

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Perioperative Desmopressin for Patients Undergoing Otolaryngologic Procedures: A Systematic Review

Barinsky

Buziashvili

Svider

et al. 2019

Otolaryngol.--head neck surg.

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ObjectiveDesmopressin (DDAVP) is a hemostatic agent used to manage bleeding in patients with hemostatic disorders, and there is a lack of published data to guide its use during otolaryngology procedures. The objective of this study was to conduct an evidence-based systematic review of the reported uses, efficacy, and adverse effects of DDAVP in the otolaryngology surgical setting.Data SourcesPubMed, MEDLINE, and EmBase were searched for articles on the use of DDAVP in otolaryngology.Review MethodsThe Methodological Index for Non-Randomized Studies criteria and Cochrane bias tool were used to assess study quality. Patient demographics, DDAVP dosing and route, and outcomes such as bleeding and adverse events were collected. A summary of evidence table was created specifying levels of evidence, benefits, and harm.ResultsNineteen studies encompassing 440 patients were included. Sixteen studies discussed DDAVP for prophylaxis, and 3 discussed postoperative use. DDAVP effectively prevented bleeding in high-risk patients and successfully facilitated a dry surgical field when necessary. DDAVP had a 100% success rate when used symptomatically. Five studies described adverse effects, including hyponatremia (12.3%), nausea (2.0%), emesis (0.9%), and seizure (0.2%). The aggregate level of evidence for its use was Level B for adenotonsillectomy, septoplasty, and turbinate procedures and Level C for rhinoplasty.ConclusionCurrent literature supports the use of DDAVP in otolaryngology surgical procedures as both a perioperative prophylactic agent and a postoperative symptomatic intervention for bleeding. Both modalities are effective with minimal adverse events. Further well-designed randomized trials are necessary to conclusively formulate guidelines for DDAVP use in otolaryngology.

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