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Abstract Purpose To report a rare variant of the posterior septal artery (PSA), which supplies blood to the posterior mucosa of the contralateral nasal septum. Case report A 31‐year‐old female patient underwent suture removal 14 days after septoplasty and developed left‐sided epistaxis 6 h after suture removal. To safely and effectively relieve the patient from epistaxis, the cauterization of the left PSA was performed under general anesthesia. However, 24 h after the first surgical hemostasis, the patient experienced epistaxis again in the right nasal cavity. We have reviewed the patient's sinus computed tomography again and found a rare variant of PSA, which is the right‐sided PSA passing through a bony canal in the left‐sided nasal septum. Discussion The variant of PSA well explained the failure of the first hemostatic surgery. Therefore, we again performed a cauterization of the right‐sided PSA, after which the patient recovered and no further epistaxis occurred. Conclusion When cauterization of PSA is used to manage posterior epistaxis, it is necessary to pay attention to the possible variation in PSA.

Background: The pedicled nasoseptal flap has been a key element in advancing the endoscopic transnasal approach (ETA) for the treatment of skull base lesions from the anterior cranial fossa to the occipitocervical junction. To preserve vascular supply, an anatomical knowledge of the location of the posterior septal artery (PSA) is essential. The objective of this work is to establish the relationship between PSA and the superior edge of the choana to define a safety margin during the opening of the sphenoidal rostrum preserving PSA. Methods: One hundred and eighty angiotomographies of the brain were assessed. The sphenopalatine artery (SPA) was evaluated in the pterygopalatine fossa and PSA at its entrance into the nasal cavity and on the sphenoidal rostrum. Results: PSA was found in all 3 tomographic planes (axial, coronal and sagittal) in 100 patients (200 PSAs). Thirty-five were male and 65 were females. Average age was 62 years with a range of 19–90 years. Total average distance between PSA and the superior edge of the choana was 8.5 mm with a range of 2.5–18 (12.45 90th percentile). Conclusion: Although the distance between the choanal edge and PSA is 8.5 mm on average, due to its variability, a distance of at least 12.45 mm for the opening of the sphenoidal sinus in the ETA approach should be considered as a safety margin. [ABSTRACT FROM AUTHOR]

Purpose: To report a rare variant of the posterior septal artery (PSA), which supplies blood to the posterior mucosa of the contralateral nasal septum., Case Report: A 31-year-old female patient underwent suture removal 14 days after septoplasty and developed left-sided epistaxis 6 h after suture removal. To safely and effectively relieve the patient from epistaxis, the cauterization of the left PSA was performed under general anesthesia. However, 24 h after the first surgical hemostasis, the patient experienced epistaxis again in the right nasal cavity. We have reviewed the patient's sinus computed tomography again and found a rare variant of PSA, which is the right-sided PSA passing through a bony canal in the left-sided nasal septum., Discussion: The variant of PSA well explained the failure of the first hemostatic surgery. Therefore, we again performed a cauterization of the right-sided PSA, after which the patient recovered and no further epistaxis occurred., Conclusion: When cauterization of PSA is used to manage posterior epistaxis, it is necessary to pay attention to the possible variation in PSA., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. World Journal of Otorhinolaryngology ‐ Head and Neck Surgery published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.)

The sphenopalatine artery gives off two main branches: the posterior lateral nasal branch and the posterior septal branch. From 2007 to 2012 17 patients were treated with cauterization and/or ligature of the sphenopalatine artery with endonasal endoscopic approach. 90 nasal dissections were performed in 45 adult cadaveric heads. We evaluated the number of branches emerging from the sphenopalatine foramen and the presence of an accessory foramen. In the surgery group, we observed a single trunk in 76 % of the patients (13/17) and a double trunk in 24 % (4/17). We found an accessory foramen in four cases. We obtained a successful result in bleeding control in 88 % of the cases. In the cadaver dissection group, 55 nasal cavities had a single arterial trunk (61 %), 30 had 2 arterial trunks (33 %) and in only 5 nasal fossae we observed 3 arterial trunks (6 %). We were able to dissect four accessory foramina. We suggest that in most cases only one or two branches are found in the sphenopalatine foramen. [ABSTRACT FROM AUTHOR]

The present experiments were performed to elucidate whether the organic slow inward current inhibitors, verapamil and nifedipine, would affect the automaticity of the atrioventricular (AV) junctional area. [ABSTRACT FROM AUTHOR]