In this paper there are reported the results of experience of many cases of severe epistaxis other than from Little's area, in the hope that this will be of some use to others.
Determination of the Source of the Bleeding.—To this end, the nasal cavity is examined with the aid of suction, after gently spraying it with cocaine solution. The bleeding may be seen to arise from:Telangiectases.Trauma. Blows on the nose, in addition to fractures, may cause a tear at the anterior attachment of the inferior turbinal. The descending palatine artery may be injured when an antronasal opening is enlarged too far backwards.A neoplasm in the nose, nasopharynx, or sinuses.The anterior ethmoid artery. Bleeding is observed in relation to the anterior end of the middle turbinal. It is often intermittent and may come in obvious spurts. The blood may trickle backwards along the
J. A. HARPMAN. Management of Epistaxis Other Than from Little's Area. Arch Otolaryngol. 1962;75(3):254–257. doi:10.1001/archotol.1962.00740040262015