Kiesselbachs

Kiesselbach's plexus, also called Kiesselbach's area or Little's area, is a vascular anastomotic region on the anterior nasal septum. It lies in the lower anterior part of the septum just inside the nostril, within what is commonly described as Kiesselbach's triangle. The plexus is formed by the anastomosis of four arteries: the septal branch of the anterior ethmoidal artery (branch of the ophthalmic artery), the sphenopalatine artery, the greater palatine artery, and the septal branch of the superior labial artery (branch of the facial artery).

Clinically, Kiesselbach's plexus is the most frequent site of anterior epistaxis, particularly in children and adolescents, though it can occur at any age. Minor trauma such as nose picking or dry mucosa can precipitate bleeding. Management is usually conservative: apply direct nasal compression by pinching the soft part of the nose for several minutes, use topical vasoconstrictors if appropriate, and avoid nose blowing. If bleeding persists, anterior nasal packing, cauterization of identifiable bleeding vessels (often with silver nitrate), or other cauterization methods may be employed. In rare cases of persistent or recurrent epistaxis, further evaluation with endoscopy, imaging, or vascular intervention may be considered.

The term honors the physician who first described this vascular complex; the region is frequently referred to as Little's area in addition to Kiesselbach's terminology.