Marioni Gino, de Filippis Cosimo
Department of Medical and Surgical Specialties, University of Padova, Padova, Italy.
Int J Pediatr Otorhinolaryngol. 2009 Dec;73 Suppl 1:S61-4. doi: 10.1016/S0165-5876(09)70012-6.
In 1930, considering the diseases of the blood and lymphatic glands in relation to otolaryngology, Goldsmith and McGregor stated that "... the otolaryngologist has frequently to deal with bleeding from the nose and throat ...". After approximately 8 decades, in particular preoperatively, the use of universal coagulation screening in children is still controversial. Aim of the present review was to offer a concise but complete discussion of clotting disorders with pediatric otolaryngological interest recognizing: (i) vascular disorders, (ii) platelet disorders, (iii) disorders of coagulation, and (iv) thrombosis.
An exhaustive review of literature was performed to investigate available data and evidences regarding pediatric otolaryngologic manifestations of bleeding disorders.
RESULTS/CONCLUSIONS: Modern otolaryngologists should be familiar with common bleeding disorders since many have head and neck manifestations. This knowledge allows the choice of appropriate pre-operative screening of surgical patients. The most important component of the preoperative assessment is the bleeding history that directs further laboratory evaluation. All otolaryngologic surgical procedures in children with bleeding disorders should be carried out with the close co-operation of the Haematology Department.
1930年，考虑到血液和淋巴腺疾病与耳鼻咽喉科的关系，戈德史密斯和麦格雷戈指出：“……耳鼻咽喉科医生经常要处理鼻出血和咽喉出血……”。大约80年后，特别是在术前，儿童普遍进行凝血筛查的做法仍存在争议。本综述的目的是对具有儿科耳鼻咽喉科意义的凝血障碍进行简明而全面的讨论，包括：（i）血管性疾病，（ii）血小板疾病，（iii）凝血障碍，以及（iv）血栓形成。
对文献进行了详尽的综述，以调查有关出血性疾病的儿科耳鼻咽喉科表现的现有数据和证据。
结果/结论：现代耳鼻咽喉科医生应熟悉常见的出血性疾病，因为许多此类疾病都有头颈部表现。这些知识有助于为手术患者选择合适的术前筛查方法。术前评估的最重要组成部分是出血史，它指导进一步的实验室检查。患有出血性疾病的儿童进行的所有耳鼻咽喉科手术都应在血液科的密切合作下进行。
