EPISTAXIS
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Dominant supply = internal Maxillary Artery (IMAX)
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IMAX branches
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Sphenopalatine artery (SPA)
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Greater Palatine artery (GPA)
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IMAX ANATOMY:
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Origin off ECA = Behind neck mandible
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IMAX course through parotid gland
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IMAX 3 Segments:
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1. Mandibular (middle meningeal artery is a bench)
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2. Pterygoid
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3. Pterygopalatine
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Proximal IMAX segmental branches (MIADA)
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Middle Meningeal (MMA)
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Inferior alveolar
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Accessory meningeal (AccMA)
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Deep auricular
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Anterior Tympanic
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Proximal IMAX branches (MIADA) —> ECA/ICA Collateralization (esp. ICA stenosis/obstruction)
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Post-Embo SE = Jaw claudication
LARGE ARROW: RETINA, CILIARY BLUSH; SMALL ARROW: BLUSH
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Ophthalmic; 2. Extraorbital ophthalmic; 3. Angular; 4. SPA; 5. Infraorbital; 6. Superior labial/lateral nasal branches; 7. Posterior superior alveolar artery; 8. Descending palatine artery; 9. Buccal; 10. Anterior deep temporal artery
References: