Hemorrhage is most commonly anterior, originating from the nasal septum. A common source of anterior epistaxis is Kiesselbach plexus, an anastomotic network of vessels on the anterior portion of the septum just superior to the posterior end of the nasal vestibule. Bleeding also may originate anterior to the inferior turbinate. Posterior hemorrhage originates in the posterior nasal cavity or nasopharynx, usually below the posterior half of the inferior turbinate or roof of the nasal cavity. Mortality is rare and usually is due to complications from hypovolemia, with severe hemorrhage or underlying disease states.
Increased morbidity is associated with nasal packing.
Posterior packing can potentially cause airway compromise. Packing in any location may lead to infection. No sexual predilection exists. Nasal hemorrhage occurs most commonly during colder months and in dry colder climates. Duration of hemorrhage and side of initial bleeding should be noted.