H. CALHOUNKARENMDB. KUPPERSMITHRONALDMD
Tonsillectomy with or without adenoidectomy is the most common major surgical procedure performed in pediatric patients1 and is often their first hemostatic challenge. Of the potential complications that may occur, excessive perioperative and postoperative bleeding are among those that cause the most angst. Although there is no foolproof, inexpensive method of preoperative detection of all patients with coagulation disorders, routine screening using PT, PTT, and BT are advocated by many practitioners. In 1995, the American Academy of Otolaryngology–Head and Neck Surgery made the recommendation that coagulation studies be used in selective patients with suggestive histories or if genetic information is unavailable.2 I strongly support this recommendation.
Derkay CS. A Cost-effective Approach for Preoperative Hemostatic Assessment in Children Undergoing Adenotonsillectomy. Arch Otolaryngol Head Neck Surg. 2000;126(5):688. doi:10.1001/archotol.126.5.688