Kiesselbach's plexus

Kiesselbach's plexus
The bones and cartilage of the nasal septum, viewed from right side. Kiesselbach's plexus (not labelled) is in the anterior inferior part of the nasal septum known as Little's area.
Details
LocationLittle's area of nose
FromAnterior ethmoidal artery, sphenopalatine artery, greater palatine artery, septal branch of superior labial artery, posterior ethmoidal artery
SuppliesNasal septum
Anatomical terminology

Kiesselbach's plexus is an anastomotic arterial network (plexus) of four or five arteries in the nose supplying the nasal septum. It lies in the anterior inferior part of the septum known as Little's area, Kiesselbach's area, or Kiesselbach's triangle. It is a common site for anterior nosebleeds.

Structure

Kiesselbach's plexus is an anastomosis of four or five arteries:

It runs vertically downwards just behind the columella, and crosses the floor of the nose. It joins the venous plexus on the lateral nasal wall.

Function

Kiesselbach's plexus supplies blood to the nasal septum.[2]

Clinical significance

Ninety percent of nosebleeds (epistaxis) occur in Kiesselbach's plexus, whereas five to ten percent originate from Woodruff's plexus.[3] It is exposed to the drying effect of inhaled air.[3] It can also be damaged by trauma from a finger nail (nose picking), as it is fragile.[3][4] It is the usual site for nosebleeds in children and young adults.[3][5] A physician may use a nasal speculum to see that an anterior nosebleed comes from Kiesselbach's plexus.[6]

History

James Lawrence Little (1836–1885), an American surgeon, first described the area in detail in 1879. Little described the area as being "about half an inch ... from the lower edge of the middle of the column [septum]".[7]

Kiesselbach's plexus is named after Wilhelm Kiesselbach (1839–1902), a German otolaryngologist who published a paper on the area in 1884. The area may be called Little's area,[4] Kiesselbach's area, or Kiesselbach's triangle.

Other

A common mnemonic used to remember the arteries of the Kiesselbach's plexus is "Kiesselbach drives his Lexus with his LEGS" (superior Labial artery, anterior and posterior Ethmoid artery, Greater palatine artery, Sphenopalatine artery).

See also

References

  1. ^ a b c d e Moore, Keith L. et al. (2014) Clinically Oriented Anatomy, 7th Ed, p.959
  2. ^ a b c d e f Drake, Richard L. (2005). Gray's anatomy for students. Wayne Vogl, Adam W. M. Mitchell, Henry Gray. Philadelphia: Elsevier / Churchill Livingstone. pp. 978–979. ISBN 0-443-06612-4. OCLC 55139039.
  3. ^ a b c d Doyle, DE (Mar 1986). "Anterior epistaxis: a new nasal tampon for fast, effective control". The Laryngoscope. 96 (3): 279–81. doi:10.1288/00005537-198603000-00008. PMID 3951304. S2CID 42072141.
  4. ^ a b Morgan, Daniel J.; Kellerman, Rick (1 March 2014). "Epistaxis: Evaluation and Treatment". Primary Care: Clinics in Office Practice. 41 (1): 63–73. doi:10.1016/j.pop.2013.10.007. ISSN 0095-4543. PMID 24439881.
  5. ^ Dhingra. Diseases of Ear,Nose and Throat. Elsevier.
  6. ^ Ando, Yuji; Iimura, Jiro; Arai, Satoshi; Arai, Chiaki; Komori, Manabu; Tsuyumu, Matsusato; Hama, Takanori; Shigeta, Yasushi; Hatano, Atsushi; Moriyama, Hiroshi (February 2014). "Risk factors for recurrent epistaxis: Importance of initial treatment". Auris Nasus Larynx. 41 (1): 41–45. doi:10.1016/j.anl.2013.05.004. ISSN 0385-8146. PMID 23791424.
  7. ^ Little, James Lawrence (1879). "A hitherto undescribed lesion as a cause of epistaxis, with four cases". The Hospital Gazette. 6 (1). New York: 5–6.