Review of thromboprophylaxis in otolaryngology-head and neck surgery

Abstract

RESEARCH TYPE: Translational.

Objective: To review and tabulate the incidence of thromboembolic complications following head and neck surgery.

Study design: Review.

Methods: Articles were identified using the MEDLINE database search engine. The relevant articles were reviewed and any thromboembolic complications were tabulated.

Results: Six articles, published between 1976 and 2007, were identified that reported on thromboembolic complications following head and neck surgery. Of these articles, four were retrospective reviews and two were prospective. Four of the studies looked at various methods of routine prophylaxis, which included several combinations of low-dose heparin, low-molecular-weight heparin, graduated compression stockings, and intermittent pneumatic compression devices. Two studies were simply investigating complications in general following head and neck surgery.

Conclusions: Head and neck cancer patients are likely at higher risk than commonly thought, and venous thromboembolism is likely much more common that what is clinically evident. It is important to develop an institutional system of risk stratification to correspond to standardizations of thromboprophylaxis that are generally accepted. Although many institutions are already attempting to do so, such as we have outlined above by extrapolating from other surgical departments, it is important to show these relationships with head and neck patients specifically to justify the high cost of these various therapies.