Kiesselbach's plexus

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Kiesselbach's plexus, also known as Little's area, is a vascular network of the anteroinferior part of the nasal septum. It is a common site for epistaxis (nosebleeds) due to its rich blood supply and superficial location.

Anatomy

Kiesselbach's plexus is located in the anterior part of the nasal septum, specifically in the region known as Little's area. This area is highly vascularized and is formed by the anastomosis of several arteries:

• The anterior ethmoidal artery, a branch of the ophthalmic artery
• The sphenopalatine artery, a branch of the maxillary artery
• The greater palatine artery, another branch of the maxillary artery
• The superior labial artery, a branch of the facial artery

Clinical Significance

Kiesselbach's plexus is the most common site for anterior epistaxis, which is the most frequent type of nosebleed. The rich vascular supply and the superficial location of the plexus make it susceptible to trauma, dryness, and other factors that can lead to bleeding.

Causes of Epistaxis

Several factors can contribute to epistaxis originating from Kiesselbach's plexus:

• Trauma: Nose picking, nasal fractures, or other injuries
• Infection: Upper respiratory infections or sinusitis
• Environmental factors: Dry air, especially in winter
• Systemic conditions: Hypertension, coagulopathies, or use of anticoagulant medications

Management

Management of epistaxis from Kiesselbach's plexus typically involves:

• Direct pressure: Pinching the nostrils together for 10-15 minutes
• Topical vasoconstrictors: Application of oxymetazoline or phenylephrine
• Cauterization: Chemical or electrical cauterization of the bleeding vessels
• Nasal packing: Insertion of nasal tampons or gauze to apply pressure and stop the bleeding

History

The plexus is named after Wilhelm Kiesselbach, a German otolaryngologist who described this vascular network in the late 19th century.

See Also

• Nasal septum
• Epistaxis
• Nasal cavity
• Otolaryngology