Anticoagulation and antiplatelet therapy in endoscopic ear surgery.

OBJECTIVES

Assess the impact of anticoagulation or antiplatelet medications on endoscopic ear surgery visibility and procedural progress.

METHODS

A case-control retrospective chart review of patients on anticoagulation/antiplatelet undergoing endoscopic ear surgery from April 2018 to April 2023 was conducted. Surgical videos were blindly rated by two surgeons utilising the Modena Bleeding Scale during clips of key operative steps; scores and outcomes were compared. Equivalence analysis was performed using two one-sided tests with an equivalence range of plus-or-minus 0.4 Modena Bleeding Scale points.

RESULTS

Fourteen cases were matched with 28 controls. Cases were more male (85.7 per cent; p < 0.01) and older (median: 54.9 years) than controls (median: 37.8; p < 0.01). Eleven cases (78.6 per cent) were on aspirin 81 mg, two (14.2 per cent) coumadin (4-6 mg) and one (7.1 per cent) aspirin 325 mg. No significant differences in Modena Bleeding Scale, blood loss, complications or outcomes were found.

CONCLUSION

This study revealed no significant difference in intra-operative visibility, progress, complications or outcomes with patients on anticoagulation/antiplatelet. Endoscopic ear surgery may be considered while on anticoagulation/antiplatelet.