If posterior epistaxis cannot be controlled, which aery is ligated:: (A) Posterior ethmoidal aery, (B) Maxillary aery, (C) Sphenopalatine aery, (D) External carotid aery
Answer is C. Ligation technique is reserved for intractable bleeding where the source cannot be located or controlled by other techniques. The hierarchy of aeries used for ligation is: Sphenopalatine aery Internal maxillary aery External carotid Aery Anterior/posterior ethmoidal aery Earlier the most common aery ligated was maxillary aery but now endonasal sphenopalatine aery ligation (ESPAL) is the ligation of choice