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The Arterial Pattern of the Upper Nasal Septum (S-Point) and Potential Role in Severe Epistaxis.
Rezende, Natália Cerqueira; Leonel, Luciano C P C; Kosugi, Eduardo Macoto; Pinheiro-Neto, Carlos Diógenes; Peris-Celda, Maria.
Afiliación
  • Rezende NC; Division of Rhinology and Skull Base Surgery, Department of Otolaryngology - Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Leonel LCPC; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Kosugi EM; Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP-EPM), Sao Paulo, Brazil.
  • Pinheiro-Neto CD; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.
  • Peris-Celda M; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Laryngoscope ; 133(9): 2075-2080, 2023 09.
Article en En | MEDLINE | ID: mdl-36382868
OBJECTIVES: The previously described S-point, corresponds to the medial projection of the middle turbinate axilla in the superior nasal septum and has been identified as a common source of severe epistaxis. The objective is to define the anatomical patterns of vascularization of the S-point area that could explain its clinical relevance. METHODS: Thirty-three nasal septums of latex-injected formalin-embalmed and fresh human cadaveric heads were dissected to analyze the arterial arrangement of the S-point area. Measurements and patterns of vascularization were described. RESULTS: The S-point area, was consistently surrounded by a single or multiple arterial anastomotic arches consistently formed superiorly by the anterior ethmoidal and posterior ethmoidal artery branches, and inferiorly by the posterior septal artery. The caliber of the arterial arches was typically larger than the caliber of the arterial branches supplying them. A single arch was present in 36.3% of septums, and multiple arches in 63.6%. The mean distance from the S-point to the anterior limit of the arch was 9 mm, to the posterior arch when the present was 3 mm, to the superior limit 6 mm, to the inferior limit 6 mm, and to the nasal roof was 10 mm. CONCLUSION: This study demonstrates the dense arterial configuration of the S point area, which is characterized by a single or multiple vascular arches of greater caliber than the branches of origin. This finding could explain why the S-point area is a frequent source of epistaxis, and guide its surgical cauterization when an obvious vascular ectasia is not visualized. LEVEL OF EVIDENCE: N/A Laryngoscope, 133:2075-2080, 2023.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Epistaxis / Tabique Nasal Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Epistaxis / Tabique Nasal Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Laryngoscope Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos