title: Otolaryngologic surgery in children with von Willebrand disease.
abstract: OBJECTIVE
  To assess the efficacy, safety, and complications of otolaryngologic surgery in children with von Willebrand disease (vWD) undergoing surgery.
  
  
  METHODS
  A prospective, controlled study of 41 children with vWD who underwent surgery between June 1, 1999, and January 31, 2001.
  
  
  METHODS
  A tertiary care, university-based children's hospital.
  
  
  METHODS
  All children had a preoperative diagnosis of vWD. The patients were treated with either a protocol that includes the use of desmopressin acetate and tranexamic acid (37 children) or factor VIII concentrate in children with a positive history of seizures (4 children).
  
  
  METHODS
  Immediate and delayed postoperative bleeding, hyponatremia, seizures, and urine output.
  
  
  RESULTS
  Two adenotonsillectomy patients (5%) had an immediate postoperative hemorrhage. Delayed postoperative bleeding was not detected in our patients. Severe hyponatremia occurred in 2 patients (1 of them with clinical manifestations).
  
  
  CONCLUSIONS
  Our management of children with vWD was efficacious in otolaryngologic surgery. One child had important adverse effects with the use of desmopressin (seizure). Thus, the use of desmopressin should be weighed and closely monitored.
authors.affiliation: C/ Arzobispo Morcillo No. 12, 1 C 28029, Madrid, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Jiménez-Yuste
authors.forename: María P
authors.initials: MP
authors.lastname: Prim
authors.forename: Juan I
authors.initials: JI
authors.lastname: De Diego
authors.forename: Ana
authors.initials: A
authors.lastname: Villar
authors.forename: Manuel
authors.initials: M
authors.lastname: Quintana
authors.forename: Iñaki
authors.initials: I
authors.lastname: Rabanal
authors.forename: Noelia
authors.initials: N
authors.lastname: Sastre
authors.forename: Fernando
authors.initials: F
authors.lastname: Hernández-Navarro
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D009225:Myringoplasty; D010038:Otorhinolaryngologic Diseases / Q000150:complications* / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D014068:Tonsillectomy; D014148:Tranexamic Acid; D014432:Tympanic Membrane / Q000601:surgery; D014842:von Willebrand Diseases / Q000150:complications*
chemical_list: D000933:Antifibrinolytic Agents; D006490:Hemostatics; D014148:Tranexamic Acid; D003894:Deamino Arginine Vasopressin