Middle Ethmoid Artery Epistaxis: A Case of Post-Traumatic Severe Bleeding

Chakapan Promsopa; Jiratchaya Janprasert; Usaporn Prapaisit; Nichana Suwanparin

doi:10.31584/jhsmr.20251230

Authors

Chakapan Promsopa Division of Allergy and Rhinology, Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Jiratchaya Janprasert Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Usaporn Prapaisit Division of Allergy and Rhinology, Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Nichana Suwanparin Division of Allergy and Rhinology, Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.20251230

Keywords:

epistaxis, middle ethmoid artery, trauma

Abstract

Post-traumatic epistaxis is a common sequela of head trauma, typically arising from injury to the nasal mucosa or disruption of vascular structures, including the anterior-posterior ethmoid and sphenopalatine arteries. The ethmoid arterial system exhibits considerable anatomical variation, with middle ethmoid arteries identified in approximately 30-36% of cases. This report presents a rare instance of post-traumatic epistaxis originating from the middle ethmoid arteries in a pediatric patient with congenital thrombocytopenia, confirmed through computed tomography imaging and intraoperative assessment. The case emphasizes diagnostic and therapeutic challenges, highlighting the role of endoscopic surgical intervention in achieving hemostasis. Understanding the anatomical complexity of the ethmoid arterial system is crucial for accurate diagnosis and optimal management in similar cases.

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