Current Concepts in Otolaryngology Epistaxis

Although bleeding from the interior of the nose may be caused by injuries, infections, septal perforations, tumors, blood dyscrasias, and even vicarious menstruation, most nosebleeds are not associated with any of these conditions. Mechanical factors, such as drying of the mucosa by overheated indoor air and trauma from nose picking, account for the largest proportion of cases, particularly in children and young adults. In this latter group, bleeding usually originates in the anterior nasal chamber, most often from a blood vessel in the mucous membrane of the nasal septum just inside the nostril (Kieselbach's area) and less often on the . . .