Endoscopic Sphenopalatine Artery Ligation in Control of Posterior Epistaxis

epistaxis is a common otolaryngologic problem, and its reported incidence ranges from 7% to 60% of the population, with only 6% seeking medical attention. It is thought to occur more frequently in men than in women, and there is an increasing incidence with age. Epistaxis reportedly occurs more frequently during dry, cold winter months.The nasal cavity is a rich vascular bed. The vasculature arises from the external carotid artery system and the internal carotid artery and its branches, the anterior and the posterior ethmoidal arteries. Branches of the external carotid artery and the internal maxillary artery and its terminal segment; the sphenopalatine artery.The major source of posterior nasal blood supply is the terminal branch of the internal maxillary artery; the sphenopalatine artery. The causes of epistaxis can be divided into: local, systemic and idiopathic causes.Local causes: Congenital Osler-Weber-Rendu disease, meningocele, encephalocele and glioma), acquired (infective, inflammatory and trauma), neoplastic (benign or malignant) and drug-dinduced.General causes: Bleeding disorders (inherited and acquired coagulopathies, platelet disorders and blood vessel disorders) and drugs (aspirin, anticoagulants and alcohol).Other causes: Liver failure, hypothyroidism and hypertension.