Kiesselbachplexus

Kiesselbach plexus, also known as Little's area, is a densely vascularized region on the anterior inferior part of the nasal septum where several arteries form an anastomotic network. It is typically located about 1 to 2 centimeters from the nostril margins, making it easily accessible for anterior nosebleeds.

Anatomy and contributors: The plexus is formed by the anastomosis of the anterior ethmoidal artery (a branch of the ophthalmic artery), the sphenopalatine artery (a branch of the maxillary artery) via its septal branches, the greater palatine artery via its septal branch, and the septal branch of the superior labial artery (a branch of the facial artery). These connections create a common site of mucosal vulnerability.

Clinical significance: Kiesselbach plexus is the most frequent source of anterior epistaxis, which accounts for the majority of nosebleeds. Posterior epistaxis, by contrast, arises less commonly from more posterior arteries and often presents with heavier bleeding.

Causes and risk factors: Nosebleeds from this area are commonly triggered by mucosal dryness, nasal trauma or picking, infections or inflammation, allergic rhinitis, and irritants. Medications that impair coagulation or platelet function can increase bleeding risk, as can recent nasal surgery or trauma, especially in children and older adults.

Management: First aid includes having the patient sit upright, lean forward, and pinch the soft part of the nostril for 5–10 minutes, avoiding nose blowing during and after. Topical vasoconstrictors and local cautery (such as silver nitrate) may be used for active bleeding. If bleeding persists or recurs, anterior nasal packing or balloon tamponade, and ENT consultation may be needed. Addressing underlying causes and hydration helps reduce recurrence.