HYPERCOAGULABILITY IN OTOLOGIC PATIENTS

Introduction: Three patients with otologic disorders developed complications related to hypercoagulability. This report was prepared to increase the awareness among otolaryngologists of the diagnosis and management of hypercoagulable states, and to encourage expert consultation when indicated. Materials and Methods: One patient with dural venous sinus thrombosis complicating an otitis media, one patient with a large glomus jugulare tumor, and one patient with a sudden sensorineural hearing loss were treated by the otolaryngology service. Suspicious thromboembolic events were evaluated by the hematology service, and appropriate anticoagulative therapy was recommended. Results: One patient with an inherited hypercoagulopathy and two patients with acquired hypercoagulopathies were treated for otologic problems. Two of the patients were stabilized and discharged on life-long anticoagulation therapy. The third patient, in spite of intensive medical and surgical support, eventually succumbed to complications to which an acquired hypercoagulable state made a significant contribution. Expert consultants made the hematologic diagnoses and treatment recommendations. Conclusion: Otolaryngologists should be aware that hypercoagulable states may now be more accurately diagnosed and characterized, and that thorough investigation of thromboembolic events may affect treatment decisions. © 1993.