Hard palate necrosis after bilateral internal maxillary artery embolization for epistaxis

Superselective embolization is an effective method of treating epistaxis that is refractory to conservative treatment. Soft tissue necrosis is a rare complication owing to the extensive collateral blood supply of the head and neck. We describe the case of a patient who developed unilateral necrosis of the mucosa overlying the hard palate after undergoing bilateral internal maxillary artery embolization. The presence of a nasopharyngeal balloon and bilateral nasal packs for 2 days after embolization may have compressed collateral vessels in the soft palate and nose and contributed to this complication. Packing should be removed as soon as possible after embolization.