PLATELET DISORDERS AS A CAUSE FOR SECONDARY HEMORRHAGE AFTER TONSILLECTOMY

Tonsillectomies are the most frequently performed ENT surgical procedu res and are potentially beset with a number of possible complications. Post-operative secondary hemorrhage still remains the most frequent c omplication despite improvements in surgical techniques and preoperati ve diagnostic evaluations. Besides unsuitable operative techniques, di sturbances of circulation and wound infections, disturbances of hemost asis may play an important part. The objective of this paper was to ex amine the relative frequency of platelet functional disorders as a pos sible cause for secondary hemorrhage after tonsillectomies. In the pas t, most of these have been related to medication use. Eighty-nine pati ents were studied and historically showed no predisposition increased hemorrhage per se or in their families or gave reasons for other facto rs favoring secondary hemorrhage. The diminution or lack of collagen o r ADP-induced agglutination served as an indication for a platelet fun ctional 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 betwee n secondary hemorrhage and abnormal deficits of collagen and ADP-induc ed agglutinations in platelet functional tests, but this was not found . Necessary preoperative studies was attempted screening for hemostasi s as well as medico-legal aspects connected with the prescription of m edicines inhibiting platelet agglutination, especially use of acetylsa licylic acid before tonsillectomies, are discussed.