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1、4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk1EPISTAXISRazaM.Jafri,FRCSAsst.Prof.OfOtolaryngologyHamdardUniversity4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk2REASONSFOREXCESSIVEBLEEDINGVascularityofnoseBothexternalandinternalcarotids.Anastomsisbetweenarteriesandveins.Blood
2、vesselsrunjustunderthemucosa-unprotected.Largervesselsontheturbinateruninbonycanals-cannotcontract.4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk3LITTLE'S(KIESSELBACH'S)AREA1/2inchfromthecaudalborderoftheseptumantero-inferiorly.Vesselsanastomosingare;Anteriorethmoid,greaterpal
3、atine,andsphenopalatine,andseptalbranchofsuperiorlabial.Bleedingmaybearterialorvenous.4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk4LateralWallFrankNetter.Ciba4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk5BloodsupplySeptumFrankNetter.Ciba4/99RazaM.Jafri,FRCSdocraza@khi.comsa
4、ts.net.pk6Little’sareaConfluenceof:AnteriorEthmoidala.GreaterPalatinea.Sphenopalatinea.Sup.Labiala.4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk7CLASSIFICATION4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk8I.AccordingtositeAnteriorSuperior;Anteriorethmoid(bleedingisfromabovea
5、nt.halfofmiddleturbinate)Inferior;Greaterpalatine,Posterior;Sphenopalatine(Bleedingisfrombelowanteriorhalfofmiddleturbinate4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk9II.PRIMARY & SECONDARY4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk10III.AccordingtoEtiologyLocalCauses:[1
6、]TraumaNosepicking,fractures.4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk11LOCALCAUSES[2]Infections:Viral:Influenza,measlesDiphtheria,lupusvulgaris,leprosy,Parasites,maggots,fungal4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk12LOCALCAUSES[3]Idiopathic:Wegner'sgranulomatosis
7、,Osler-Weber-Rendau'ssyn.,atrophicrhinitis4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk13LOCALCAUSES[4]Neoplasms:Ofthenose,nasopharynxandsinuses.AngiofibromaCarcinomoftheNasopharynx4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk14LocalCauses[4]Miscellaneous:Septalspur,foreignb
8、odies4/99RazaM.Jafri,FRCSdocraza@khi.comsats.net.pk15GeneralC
