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As is well known, epistaxis frequently occurs from dilated blood vessels (Kiesselbach's plexus) near the anterior part (Little's area) of the nasal septum. Often this plexus of vessels can be seen to communicate with one larger vessel, which crosses the floor of the nasal vestibule in a transverse direction. Usually these vessels are venous, but sometimes they appear to be arterial and to represent septal branches of the superior coronary artery. Study of cadavers reveals the origin of the septal arteries.
Cauterization (chemical, thermal, electrical) has been commonly used to ablate these dilated vessels from the septum. After cauterization there sometimes is additional bleeding when the crust falls off, and in the end permanent mucosal crusting is occasionally seen. Subperichondrial elevation of the bleeding areas has given good results, but this is rather formidable compared to the simple procedure to be described here. Three years ago I conceived the idea
ROSENVOLD LK. INTRANASAL LIGATION FOR EPISTAXIS. Arch Otolaryngol. 1940;32(6):1109–1110. doi:10.1001/archotol.1940.00660021117017