A Case of Bilateral Tonsillectomy and Nasal Septoplasty in a Patient with Hemophilia A

Abstract

In patients with coagulopathies such as hemophilia who undergo surgical procedures, coagulation factor supplementation during the perioperative period is crucial. Herein, we report the case of a patient with a history of hemophilia A who underwent bilateral tonsillectomy, septoplasty, and submucous turbinectomy.

The patient, a 40-year-old male, presented to us with purulent nasal discharge, nasal obstruction, pharyngeal pain, and snoring. We diagnosed the patient as having chronic tonsillitis and deflected nasal septum, and performed bilateral tonsillectomy, septoplasty, and submucous turbinectomy. We collaborated with a hematologist specialized in blood disorders to ensure that the patient received Factor VIII supplementation during the perioperative period.

Transient bleeding was observed post-tonsillectomy after the completion of Factor VIII supplementation, however, hamostasis was achieved by additional administration of Factor VIII. Factor VIII supplementation was also undertaken during the septoplasty and submucous turbinectomy procedures, without postoperative bleeding.

All of tonsillectomy, septoplasty, and submucous turbinectomy carry a high risk of bleeding. Therefore, when performing these surgeries on patients with coagulation abnormalities, collaboration with a hematologist specialized in blood disorders for perioperative bleeding control is essential.