Recurrent Massive Epistaxis from an Anomalous Posterior Ethmoid Artery

Area of Science:

• Otorhinolaryngology
• Vascular Surgery
• Medical Imaging

Background:

• Recurrent posterior epistaxis poses significant management challenges.
• The ethmoid arteries are common sources of severe nasal bleeding.
• Anatomical variations can complicate epistaxis treatment.

Purpose of the Study:

• To report a challenging case of recurrent posterior epistaxis.
• To highlight the role of anatomical variations in epistaxis management.
• To emphasize the importance of identifying ethmoidal artery anomalies.

Main Methods:

• Surgical intervention for epistaxis.
• Diagnostic cranial angiography.
• Case review and analysis.

Main Results:

• A 50-year-old male patient experienced recurrent left posterior epistaxis.
• Three surgical treatments were required for bleeding control.
• An abnormal course of the left posterior ethmoidal artery was identified as the cause.
• Operator experience and radiological support were essential for successful management.

Conclusions:

• Anomalous ethmoidal artery courses can lead to difficult-to-manage epistaxis.
• Cranial angiography is vital for identifying vascular anomalies in epistaxis.
• Careful anatomical assessment, especially of ethmoid arteries, is crucial for treating nasal bleeding originating from the nasal roof.