Endoscopic management of anterior and posterior epistaxis

The current management for epistaxis encompasses a wide variety of options that include pressure and intranasal decongestants, nasal packing, chemical and electrical cauterization, endovascular embolization, and surgical ligation of offending vessels. For episodes of epistaxis refractory to the more conservative measures, the use of the rigid endoscope has significantly increased the efficacy of therapeutic techniques by improving visualization of and access to intranasal bleeding sites. This review highlights the endoscopic approach to manage cases of severe epistaxis through direct cauterization, ligation of the sphenopalatine artery, and ligation of the anterior ethmoid artery.