What Is the Kiesselbach Plexus?
The nasal septum, or wall dividing the nose's left and right sides, receives oxygenated blood via the Kiesselbach plexus, a vascular network of five arteries that form the plexus when they anastomose or join.
The nasal septum's anterior inferior (lower front) quadrant receives blood supply from the Kiesselbach plexus. Other names for this region include Little's area, Kiesselbach's area, and Kiesselbach's triangle.
The Kiesselbach plexus is named after the German otolaryngologist Wilhelm Kiesselbach (1839–1902). Both children and adults frequently get nosebleeds (such as epistaxis) at this location.
Where Is Kiesselbach Plexus?
The Kiesselbach plexus is situated in the nasal cavity in the anterior inferior quadrant of the nasal septum, where many arteries anastomose to form the plexus, or vascular network. It is important for controlling nasal airflow and preserving the blood supply to the nasal mucosa.
The following five major arteries facilitate the development of Kiesselbach's plexus:
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Sphenopalatine Artery: The sphenopalatine artery provides blood to the posterior region of the nasal cavity by dividing from the maxillary artery, which begins below the jawbone.
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Anterior Ethmoidal Artery: The anterior ethmoidal artery supplies blood to the anterior region of the nasal cavity. It originates from the ophthalmic artery, which is situated behind the eye.
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Posterior Ethmoidal Artery: The posterior ethmoidal artery, which also arises from the ophthalmic artery, provides blood flow to the nose cavity.
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Septal Branch of the Superior Labial Artery: The septal branch of the superior labial artery, which is a branch of the facial artery, provides blood to the nasal septum and other superficial facial features.
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Greater Palatine Artery: The greater palatine artery supplies blood to the posterior region of the nasal cavity and is a terminal branch of the maxillary artery.
The external carotid artery, which supplies the sphenopalatine, superior labial, and greater palatine arteries, and the internal carotid artery, which supplies the anterior and posterior ethmoidal arteries, supply the arterial blood supply to the Kiesselbach plexus. The pterygoid plexus, ophthalmic, and facial veins drain the blood in this region.
What Is the Function of Kiesselbach's Plexus?
The nose receives a substantial blood supply from the Kiesselbach plexus to regulate the body's air intake. The arteries of the Kiesselbach plexus release heat from the blood into the air as it passes through the nose and into the body. This air must be heated for efficient gas exchange to occur after the air enters the lungs. The Kiesselbach plexus is the most frequently occurring source of nasal bleeding (epistaxis) due to its abundant blood supply.
What Is the Clinical Significance of Kiesselbach's Plexus?
The primary job of Kiesselbach's plexusis to use heat exchange between the air and the arteries to regulate the temperature of the air inhaled by the nose. Due to its abundant blood supply, the Kiesselbach plexus is the most common source of nosebleeds.
The clinical consequences of Kiesselbach's plexus are multifaceted, mainly associated with its susceptibility to trauma, epistaxis (nosebleeds), and surgical procedures.
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Epistaxis: Bleeding nosebleeds are a common medical condition, with the most common location of bleeding being the Kiesselbach's plexus. People are more susceptible to epistaxis if they have had trauma, dry air, sinus infections, or certain medical disorders. To stop the bleeding, cauterization, nasal packing, or direct pressure to the Kiesselbach's plexus are common epistaxis management techniques.
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Surgical Procedures: To reduce the risk of excessive bleeding, a detailed understanding of Kiesselbach's plexus is necessary for surgical operations affecting the nasal septum, such as septoplasty (straightening the nasal septal wall) or nasal cauterization. When working with the nasal mucosa, surgeons need to use caution so as not to damage the blood vessels in Kiesselbach's plexus.
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Nasal Septal Hematoma: A nasal septal hematoma is an accumulation of blood inside the nasal septum that can occur due to trauma to the nasal septum. If treatment is not received, a septal hematoma can compress the nasal cartilage and cause problems like a septal abscess or nasal deformity. To avoid these consequences, draining the hematoma could be required. This usually entails an incision and the removal of the blood clot without damaging the Kiesselbach's plexus.
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Nasal Polyps: Nasal polyps are benign growths within the nasal cavity that can form as a result of inflammatory disorders such as chronic rhinosinusitis (air-filled cavities around the nasal cavity are inflamed). Symptoms, including nasal congestion, loss of smell, and facial pressure, can be brought on by nasal polyps blocking the nasal passageways. In certain instances, surgical excision of nasal polyps may be necessary, and great care should be taken to maintain the integrity of Kiesselbach's plexus to reduce the danger of bleeding during the process.
How to Manage Bleeding From Kiesselbach's Plexus?
The following methods prevent bleeding or epistaxis from Kiesselbach's plexus.
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First Aid: First aid actions can be taken to stop the bleeding in cases of minor epistaxis. This entails staying erect and directly pressing the afflicted nose for ten to fifteen minutes. Applying cold compresses to the nose bridge helps narrow blood vessels and lessen bleeding.
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Medical Management: Medical treatment might be required for more severe or recurrent epistaxis. Saline nasal sprays and nasal decongestants can aid in reducing inflammation and hydrating the nasal mucosa. To seal off the injured blood vessels, cauterization of the bleeding site with chemicals such as silver nitrate or electric cautery may be used.
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Surgical Management: Surgery may be necessary if the epistaxis is severe or persistent and does not respond to medication. Submucosal excision or septoplasty, two types of septal surgery, may be necessary to address any underlying anatomical defects causing the epistaxis.
How to Prevent Bleeding From Kiesselbach's Plexus?
Bleeding from Kiesselbach's plexus can be prevented by
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Nasal Hygiene: Maintaining the health of the nasal mucosa and lowering the risk of epistaxis can be accomplished through regular nasal hygiene activities, such as using saline nasal irrigation and refraining from picking your nose excessively.
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Humidification: Dry air can cause nasal mucosa irritation and nosebleeds. Use a humidifier or nasal saline sprays to keep the nasal passages wet and lower the risk of epistaxis.
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Avoiding Trauma: Preventing nasal trauma can help avoid damage to Kiesselbach's plexus and consequent epistaxis. Examples of such trauma include contact sports and other activities that may result in nose injury.
Conclusion
Kiesselbach's plexus is an important circulatory network created by the anastomosis of many arteries within the nasal septum. Due to its location, it is prone to trauma. It is involved in the pathophysiology and treatment of several nasal disorders, such as surgical procedures, epistaxis, nasal septal hematomas, and nasal polyps. To properly manage nasal illnesses and avoid difficulties associated with their disruption, healthcare providers need to be completely aware of the anatomy and clinical relevance of Kiesselbach's plexus.
