Anatomy

The nose functions to warm and humidify air and therefore requires a vigorous blood supply ( Fig. 233-1). Its blood supply originates from both the internal and external carotid arteries. The posterior and inferior aspects of the nasal cavity are supplied by the sphenopalatine artery, which is a branch of the maxillary artery. The internal carotid artery gives rise to the ophthalmic artery, which supplies the anterior-superior nasal cavity by the anterior and posterior ethmoidal arteries. The nasal septum receives its blood supply from multiple arteries. The superior labial branch of the facial artery supplies the vestibule and inferior-anterior septum. The posterior and superior septum is supplied by branches of the sphenopalatine, anterior ethmoidal, and posterior ethmoidal arteries. These all join to form Kiesselbach's plexus.

FIG. 233-1. Arterial blood supply to the nasal cavity. The most common site of nasal hemorrhage is at Little area, located on the nasal septum. The most common site of posterior epistaxis is at the lateral nasal branch of the sphenopalatine artery, which enters the nasal cavity behind the middle turbinate. AE, anterior ethmoid; GP, greater palatine; LA, Little area; PE, posterior ethmoid; SL, superior labial; SP, sphenopalatine (lateral nasal branch).

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