title: Perioperative Management of Antithrombotic Therapy in Common Otolaryngologic Surgical Procedures: State of the Art Review.
abstract: OBJECTIVE
  The perioperative management of patients undergoing otolaryngologic procedures is increasingly complicated by the use of newer antithrombotic agents. Furthermore, with advances in anesthesia and surgical technique, otolaryngologists are presented with the challenge of operating on patients with advanced comorbid diseases. The objective of this review is to provide evidence-based recommendations on perioperative antithrombotic management for common otolaryngologic procedures.
  
  
  METHODS
  PubMed/MEDLINE.
  
  
  METHODS
  Selected literature on patient-specific thromboembolic risk, rate of bleeding complications in otolaryngologic procedures, and the interruption of antithrombotic therapy is reviewed and interpreted by expert opinion.
  
  
  CONCLUSIONS
  By stratifying patients into either low thromboembolic risk (≤ 5%) or high thromboembolic risk (> 5%) and interpreting this in the context of procedural bleed risk and potential clinical consequences in the event of a bleed, otolaryngologists can make evidence-based decisions to determine the appropriate perioperative management of antithrombotic therapy.
  
  
  CONCLUSIONS
  When the perioperative management of antithrombotic therapy is being decided, 3 critical factors must be considered systematically: the patient's inherent thromboembolic risk, the risk and potential consequences of bleeding related to the procedure, and the timing of interruption of thromboembolic therapy.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Wayne D
authors: WD
authors: Hsueh
authors: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
authors: Peter H
authors: PH
authors: Hwang
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, USA wmabuzeid@gmail.com.
authors: Waleed M
authors: WM
authors: Abuzeid
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications; D003331:Coronary Vessels; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006470:Hemorrhage; D006801:Humans; D061185:Mechanical Thrombolysis; D013517:Otorhinolaryngologic Surgical Procedures; D019990:Perioperative Care; D015607:Stents / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000209:etiology
chemical_list: D005343:Fibrinolytic Agents
keywords: anticoagulation; antithrombotics; perioperative management