[Disorders of thrombocyte function as a cause of postoperative hemorrhage after tonsillectomy]

Tonsillectomies are the most frequently performed ENT surgical procedures and are potentially beset with a number of possible complications. Post-operative secondary hemorrhage still remains the most frequent complication despite improvements in surgical techniques and preoperative diagnostic evaluations. Besides unsuitable operative techniques, disturbances of circulation and wound infections, disturbances of hemostasis may play an important part. The objective of this paper was to examine the relative frequency of platelet functional disorders as a possible cause for secondary hemorrhage after tonsillectomies. In the past, most of these have been related to medication use. Eighty-nine patients were studied and historically showed no predisposition increased hemorrhage per se or in their families or gave reasons for other factors favoring secondary hemorrhage. The diminution or lack of collagen or ADP-induced agglutination served as an indication for a platelet functional disorder. Ten percent of the 89 patients experienced secondary hemorrhage, with platelet functional disorders proved in 40% of these patients. Because of these results a correlation was attempted between secondary hemorrhage and abnormal deficits of collagen and ADP-induced agglutinations in platelet functional tests, but this was not found. Necessary preoperative studies was attempted screening for hemostasis as well as medico-legal aspects connected with the prescription of medicines inhibiting platelet agglutination, especially use of acetylsalicylic acid before tonsillectomies, are discussed.