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Clinical Problem Solving: Radiology
Dec 2012

Radiology Quiz Case 2: Diagnosis

Arch Otolaryngol Head Neck Surg. 2012;138(12):1188-1189. doi:10.1001/archotol.138.12.1188

More than 60% of the adult population experience at least 1 episode of epistaxis during their lifetime.1 Most cases of epistaxis occur in the anterior septal area at Kiesselbach plexus, or Little area, which is a localized region of mucosa of the anteroinferior nasal septum that is supplied by branches of the sphenopalatine, greater palatine, and facial arteries. Epistaxis in this location is readily accessible and treatable by cautery or anterior nasal packing. Posterior epistaxis often requires more aggressive measures, including posterior nasal packing and endoscopic cauterization. Epistaxis that is refractory to initial treatment attempts can often be successfully treated by endovascular embolization.