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Otolaryngologic surgery in children with von Willebrand disease

Victor Jiménez-Yuste1, María P Prim, Juan I De Diego

  • 1C/ Arzobispo Morcillo No. 12, 1 C 28029, Madrid, Spain.

Archives of Otolaryngology--Head & Neck Surgery
|December 17, 2002
PubMed

Insights

Otolaryngologic surgery in children with von Willebrand disease (vWD) is effective, but desmopressin use requires caution due to potential seizures. Careful monitoring is essential for managing bleeding risks and adverse effects.

Area of Science:

  • Pediatric Otolaryngology
  • Hematology
  • Pharmacology

Background:

  • Von Willebrand disease (vWD) presents unique challenges in pediatric surgical patients.
  • Otolaryngologic procedures are common in children and may be complicated by bleeding disorders.

Purpose of the Study:

  • To evaluate the safety and efficacy of otolaryngologic surgery in children diagnosed with von Willebrand disease (vWD).
  • To assess postoperative bleeding, hyponatremia, seizures, and urine output as key outcome measures.

Main Methods:

  • A prospective, controlled study involving 41 pediatric patients with vWD undergoing surgery.
  • Treatment protocols included desmopressin acetate and tranexamic acid, or factor VIII concentrate for specific cases.
  • Data collection focused on immediate/delayed bleeding, hyponatremia, seizures, and urine output.

Main Results:

  • Two patients (5%) experienced immediate postoperative hemorrhage following adenotonsillectomy.
  • No delayed postoperative bleeding was observed.
  • Severe hyponatremia occurred in two patients, with one exhibiting clinical symptoms.

Conclusions:

  • The implemented management strategy for children with vWD undergoing otolaryngologic surgery proved efficacious.
  • One patient experienced a seizure, an adverse effect linked to desmopressin, highlighting the need for careful administration and monitoring.
Abstract

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