Hypercoagulability in otologic patients.
BACKGROUND
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.


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.


CONCLUSIONS
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.
Gold
S
S
Department of Otolaryngology, University of Pittsburgh, School of Medicine, PA 15213.
Kamerer
D B
DB
Hirsch
B E
BE
Cass
S P
SP
D000328:Adult; D000925:Anticoagulants / Q000145:classification / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000503:physiopathology; D004432:Ear, Middle / Q000503:physiopathology*; D005260:Female; D005925:Glomus Jugulare Tumor / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D034381:Hearing Loss / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011859:Radiography; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
D000925:Anticoagulants