Posterior epistaxis in elderly hypertensive patients is most commonly from which vessel?

• A Sphenopalatine artery (terminal branch of internal maxillary artery) ✓
• B Anterior ethmoidal artery
• C Kiesselbach's plexus on Little's area
• D Posterior ethmoidal artery

Explanation

Posterior epistaxis, which is severe, recurrent, and occurs predominantly in elderly hypertensive patients, arises from the sphenopalatine artery (and its branches — posterior lateral nasal artery) in the posterior nasal cavity. This vessel is the most common source of clinically significant epistaxis requiring surgical (endoscopic) ligation or embolisation. Anterior epistaxis (more common overall) arises from Kiesselbach's plexus on Little's area. Anterior ethmoidal artery is responsible for high anterior bleeds.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.