Romero has served his three-match suspension and is expected to be recalled to Ange Postecoglou's first XI, most likely replacing Emerson Royal to partner Ben Davies at centre-back.
Eric Dier missed Spurs' thrilling 3-3 draw with Manchester City last weekend after sustaining a muscle injury in training, and he remains a doubt for Thursday, while Micky van de Ven (hamstring), Rodrigo Bentancur, James Maddison, Ashley Phillips, Alfie Whiteman (all ankle), Pape Matar Sarr (muscle), Manor Solomon, Ivan Perisic (both knee) and Ryan Sessegnon (thigh) all remain sidelined.
Richarlison made a surprise return to the matchday squad against Man City just 24 days after undergoing groin surgery, coming off the substitutes' bench in the closing stages, and the Brazilian forward is in contention to play again against the Hammers.
It remains to be seen whether Richarlison will be thrown back into the starting lineup on Thursday, though, so Son Heung-min and Dejan Kulusevski - who both scored against Man City - could once again link up with Brennan Johnson and Bryan Gil in the final third.
Giovani Lo Celso was also on the scoresheet at the Etihad Stadium, netting his second goal in as many games, and he will likely continue in centre-midfield alongside Yves Bissouma, with Pierre-Emile Hojbjerg set to provide cover as a substitute.
The aforementioned centre-back partnership of Romero and Davies is set to be sandwiched between full-backs Pedro Porro and Destiny Udogie, while Guglielmo Vicario - who has conceded 12 goals in his last five appearances - will continue between the sticks.
Tottenham Hotspur possible starting lineup: Vicario; Porro, Romero, Davies, Udogie; Bissouma, Lo Celso; Johnson, Kulusevski, Gil; Son