title: Non-sphenopalatine dominant arterial supply of the nasal cavity: an unusual anatomical variation.
abstract: OBJECTIVE
  We present a rare and clinically relevant anomaly of the sphenopalatine artery in relation to its blood supply of the nasal mucosa, with implications for the management of epistaxis.
  
  
  METHODS
  Case report and review of the world literature, using Medline through Pub Med (1950-2005), EMBASE (1980-2005) and Ovid (1958-2005), searching for papers using a combination of terms including 'spheno-palatine artery', 'anterior ethmoidal artery' and 'epistaxis'.
  
  
  RESULTS
  In the presented case of refractory epistaxis, endoscopic and subsequent endovascular management failed to identify a significant supply from the sphenopalatine arteries bilaterally. The main supply was found to be from the anterior ethmoidal arteries.
  
  
  CONCLUSIONS
  After a detailed search, the authors failed to locate any similar case in the English literature.
authors.affiliation: Department of Otorhinolaryngology, Queen's Medical Centre, University of Nottingham, UK. drdbiswas@hotmail.com
authors.forename: D
authors.initials: D
authors.lastname: Biswas
authors.forename: S K
authors.initials: SK
authors.lastname: Ross
authors.forename: A
authors.initials: A
authors.lastname: Sama
authors.forename: A
authors.initials: A
authors.lastname: Thomas
mesh_terms: D000369:Aged, 80 and over; D001158:Arteries / Q000033:anatomy & histology; D004844:Epistaxis / Q000517:prevention & control / Q000628:therapy*; D005004:Ethmoid Bone / Q000098:blood supply; D006801:Humans; D008297:Male; D009296:Nasal Cavity / Q000098:blood supply*; D009297:Nasal Mucosa / Q000098:blood supply*; D016896:Treatment Outcome