A 40-year-old male presents with posterior epistaxis not controlled by anterior nasal packing. Endoscopic examination under general anaesthesia identifies the bleeding point at the posterolateral nasal wall, posterior to the posterior end of the inferior turbinate. The vessel responsible is most likely:
- A Anterior ethmoidal artery
- B Posterior ethmoidal artery
- C Sphenopalatine artery ✓
- D Greater palatine artery
Explanation
The sphenopalatine artery (terminal branch of the internal maxillary artery) is responsible for the majority of posterior epistaxis. It enters the nasal cavity through the sphenopalatine foramen at the posterior end of the middle turbinate and supplies the posterior septum, posterolateral nasal wall, and turbinates. For refractory posterior epistaxis, endoscopic sphenopalatine artery ligation at the sphenopalatine foramen (just posterior to the posterior end of the middle turbinate) is the surgical treatment of choice. The anterior and posterior ethmoidal arteries supply the superior/anterior nasal cavity.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.