TRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.
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February 2026BACKGROUND
Patients undergoing elective otolaryngologic surgery may have a recent history of stroke. The optimal timing for elective surgery after a stroke has been the subject of significant debate. The primary concern in scheduling elective surgery after a stroke, particularly in the early months post-stroke, is the elevated risk of recurrent ischemic stroke, major adverse cardiac events, and mortality. As the population ages and stroke rates rise, this question becomes increasingly relevant in clinical practice. In this Triological Society Best Practice, we explore whether, and how long, elective otolaryngologic surgery should be delayed following stroke based on a larger selection of literature exploring this question in the broader category of noncardiac elective surgery.
BEST PRACTICE
The preponderance of evidence suggests delaying elective surgery in otolaryngology following a stroke for six to 14 months depending on patient factors, the complexity of the surgery, and urgency. While the highest risks are concentrated in the first three months, it appears that risks continue to decline significantly through the first year post-stroke. For high-risk patients or those undergoing complex procedures, a longer delay of nine to 14 months is advisable. Importantly, individualized assessments remain critical to balance the risks of delaying otolaryngologic surgery with the benefits of addressing underlying surgical conditions.
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