The sphenopalatine artery enters the back of thenasal cavity, the inside of the nose, providing blood supply to the inner and outer walls of the nasal cavity and to the adjacent sinuses. It is clinically important since it is a frequent cause of nosebleeds.
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Anatomy
Anatomy and Function of the Nasal Bone
Location
The sphenopalatine artery is the last branch of the maxillary artery, which is a branch of theexternal carotid artery, a major artery supplying the head and neck. The maxillary artery runs through thepterygopalatine fossaand passes through the sphenopalatine foramen. At this point, it becomes the sphenopalatine artery.
Structure
The sphenopalatine artery gives off several branches. It gives off a pharyngeal branch, then divides in the nasal cavity into the lateral nasal artery and septal nasal artery. The lateral nasal artery, as its name implies, supplies the lateral (outer) wall of the nasal cavity and themaxillary sinuses, which are located lateral to the nasal cavity.
Anatomical Variations
As with many arteries, anatomy can vary slightly from person to person. For example, the sphenopalatine artery usually divides into two branches after entering the nasal cavity. However, in some patients, the artery may divide before entering the cavity. In others, the sphenopalatine artery may divide into three or more branches. Surgeons planning nasal surgeries should be aware of potential variations in anatomy.
Function
The septal nasal artery supplies blood to the nasal septum, along the medial (inner) wall of the nasal cavity, and to the roof of the nasal cavity. Branches of the artery run forward along the septum and anastomose (interconnect) with branches of the anterior ethmoid artery, greater palatine artery, and superior labial artery, forming a network of vessels called Kiesselbach’s plexus.
Clinical Significance
The sphenopalatine artery and its branches are an important cause ofnosebleeds(epistaxis). Nosebleeds can be classified as anterior or posterior, depending on the vessels that supply the injured mucosa. Anterior nosebleeds, the most common type, typically arise from Kiesselbach’s plexus. Posterior nosebleeds are less common, and typically arise from branches of the sphenopalatine artery, though branches of the internal carotid artery may also be involved.
Nosebleeds are usually the result of trauma or irritation to the nasal mucosa, the lining of the nasal cavity. Potential causes of mucosal injury include:
Inadvertent injury to the artery may cause abnormal ballooning of the vessel, or pseudoaneurysm, which leads to severe bleeding.
Nosebleed Causes and Treatment
Treatment
Although both anterior and posterior nosebleeds may cause rapid bleeding, minor bleeds are more likely to be anterior. The treatment differs depending on the source of the bleeding. Anterior nosebleeds may stop on their own, or respond to conservative measures such as pinching the nose.
How to Stop a Nosebleed
Anterior Nosebleeds
More significant anterior nosebleeds may require more extensive treatment, such as:
Posterior Nosebleeds
Posterior nosebleeds may result in significant bleeding. Though nasal packing or balloon catheters may be used as an initial measure, most patients with a posterior bleed need to be referred to an emergency department where an otolaryngologist is available. Stopping the bleeding may eventually require a surgical procedure, such as ligation or embolization of the responsible artery.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1Kanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg.Gordhan A.Management of hemorrhagic pseudoaneurysmal arteriovenous fistula of the sphenopalatine artery.Case Rep Vasc Med. 2013;2013:539196. doi: 10.1155/2013/539196UpToDate.Approach to the Adult with Epistaxis.Additional ReadingAjeet Gordhan, “Management of Hemorrhagic Pseudoaneurysmal Arteriovenous Fistula of the Sphenopalatine Artery”,Case Reports in Vascular Medicine, vol. 2013, Article ID 539196, 4 pages, 2013. https://doi.org/10.1155/2013/539196Bradac G.B. (2017) External Carotid Artery. In: Applied Cerebral Angiography. Springer, Cham.https://doi.org/10.1007/978-3-319-57228-4_3Byrne J.V. (2012) Cranial Arterial Anatomy. In: Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. Springer, Berlin, Heidelberg.https://doi.org/10.1007/978-3-642-19154-1_2Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1Harrison Alter, MD. Approach to the Adult with Epistaxis.www.uptodate.comKanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74380-4_12Orrett E. Ogle, Robert J. Weinstock, Ezra Friedman, Surgical Anatomy of the Nasal Cavity and Paranasal Sinuses, Oral and Maxillofacial Surgery Clinics of North America, Volume 24, Issue 2, 2012, Pages 155-166, https://doi.org/10.1016/j.coms.2012.01.011.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1Kanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg.Gordhan A.Management of hemorrhagic pseudoaneurysmal arteriovenous fistula of the sphenopalatine artery.Case Rep Vasc Med. 2013;2013:539196. doi: 10.1155/2013/539196UpToDate.Approach to the Adult with Epistaxis.Additional ReadingAjeet Gordhan, “Management of Hemorrhagic Pseudoaneurysmal Arteriovenous Fistula of the Sphenopalatine Artery”,Case Reports in Vascular Medicine, vol. 2013, Article ID 539196, 4 pages, 2013. https://doi.org/10.1155/2013/539196Bradac G.B. (2017) External Carotid Artery. In: Applied Cerebral Angiography. Springer, Cham.https://doi.org/10.1007/978-3-319-57228-4_3Byrne J.V. (2012) Cranial Arterial Anatomy. In: Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. Springer, Berlin, Heidelberg.https://doi.org/10.1007/978-3-642-19154-1_2Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1Harrison Alter, MD. Approach to the Adult with Epistaxis.www.uptodate.comKanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74380-4_12Orrett E. Ogle, Robert J. Weinstock, Ezra Friedman, Surgical Anatomy of the Nasal Cavity and Paranasal Sinuses, Oral and Maxillofacial Surgery Clinics of North America, Volume 24, Issue 2, 2012, Pages 155-166, https://doi.org/10.1016/j.coms.2012.01.011.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1Kanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg.Gordhan A.Management of hemorrhagic pseudoaneurysmal arteriovenous fistula of the sphenopalatine artery.Case Rep Vasc Med. 2013;2013:539196. doi: 10.1155/2013/539196UpToDate.Approach to the Adult with Epistaxis.
Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1
Kanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg.
Gordhan A.Management of hemorrhagic pseudoaneurysmal arteriovenous fistula of the sphenopalatine artery.Case Rep Vasc Med. 2013;2013:539196. doi: 10.1155/2013/539196
UpToDate.Approach to the Adult with Epistaxis.
Ajeet Gordhan, “Management of Hemorrhagic Pseudoaneurysmal Arteriovenous Fistula of the Sphenopalatine Artery”,Case Reports in Vascular Medicine, vol. 2013, Article ID 539196, 4 pages, 2013. https://doi.org/10.1155/2013/539196Bradac G.B. (2017) External Carotid Artery. In: Applied Cerebral Angiography. Springer, Cham.https://doi.org/10.1007/978-3-319-57228-4_3Byrne J.V. (2012) Cranial Arterial Anatomy. In: Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. Springer, Berlin, Heidelberg.https://doi.org/10.1007/978-3-642-19154-1_2Gras-Cabrerizo, J.R., Ademá-Alcover, J.M., Gras-Albert, J.R.et al.Anatomical and surgical study of the sphenopalatine artery branches.Eur Arch Otorhinolaryngol271, 1947–1951 (2014). https://doi.org/10.1007/s00405-013-2825-1Harrison Alter, MD. Approach to the Adult with Epistaxis.www.uptodate.comKanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74380-4_12Orrett E. Ogle, Robert J. Weinstock, Ezra Friedman, Surgical Anatomy of the Nasal Cavity and Paranasal Sinuses, Oral and Maxillofacial Surgery Clinics of North America, Volume 24, Issue 2, 2012, Pages 155-166, https://doi.org/10.1016/j.coms.2012.01.011.
Ajeet Gordhan, “Management of Hemorrhagic Pseudoaneurysmal Arteriovenous Fistula of the Sphenopalatine Artery”,Case Reports in Vascular Medicine, vol. 2013, Article ID 539196, 4 pages, 2013. https://doi.org/10.1155/2013/539196
Bradac G.B. (2017) External Carotid Artery. In: Applied Cerebral Angiography. Springer, Cham.https://doi.org/10.1007/978-3-319-57228-4_3
Byrne J.V. (2012) Cranial Arterial Anatomy. In: Tutorials in Endovascular Neurosurgery and Interventional Neuroradiology. Springer, Berlin, Heidelberg.https://doi.org/10.1007/978-3-642-19154-1_2
Harrison Alter, MD. Approach to the Adult with Epistaxis.www.uptodate.com
Kanowitz S., Citardi M., Batra P. (2009) Contemporary Management Strategies for Epistaxis. In: Stucker F., de Souza C., Kenyon G., Lian T., Draf W., Schick B. (eds) Rhinology and Facial Plastic Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74380-4_12
Orrett E. Ogle, Robert J. Weinstock, Ezra Friedman, Surgical Anatomy of the Nasal Cavity and Paranasal Sinuses, Oral and Maxillofacial Surgery Clinics of North America, Volume 24, Issue 2, 2012, Pages 155-166, https://doi.org/10.1016/j.coms.2012.01.011.
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