Indications for internal maxillary artery ligation in the treatment of epistaxis

Following a review of 13 cases of epistaxis treated by internal maxillary artery with anterior ethmoidal artery ligation over a three year period at the Toronto General Hospital certain indications for ligation have evolved. These are: 1) hospital stay longer than five days, 2) total number of nasal packs more than three, 3) concomitant disease aggravating control, 4) blood transfusion in excess of five units, 5) massive epistaxis.