How is arterial ligation performed on the ethmoidal artery in the treatment of epistaxis (nosebleed)?

Updated: May 08, 2020
  • Author: Quoc A Nguyen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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If bleeding occurs high in the nasal vault, consider ligation of the anterior ethmoidal artery, the posterior ethmoidal artery, or both. These arteries are approached through an external ethmoidectomy incision.

The anterior ethmoidal artery is usually found approximately 22 mm (range, 16-29 mm) from the anterior lacrimal crest. If clipping the artery does not stop the bleeding, then the posterior ethmoidal artery may be ligated. This artery is found approximately 12 mm posterior to its anterior counterpart. It should be clipped, not cauterized, because it is only 4-7 mm anterior to the optic nerve.

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