title: Palatovaginal (pharyngeal) artery: clinical implication and surgical experience.
abstract: The palatovaginal or pharyngeal artery is a small branch of the internal maxillary artery supplying the nasopharynx. Bleeding from this artery is exceptional and only one case of traumatic epistaxis from this artery has been reported previously. We report a case of a 66-year-old male presenting with right recurrent posterior epistaxis. Endoscopic dissection of the pterygopalatine fossa and direct visualization of the palatosphenoidal canal permitted to identify the origin of bleeding, and coagulation of the pharyngeal artery solved the epistaxis. Although rare, intractable posterior epistaxis may arise from the pharyngeal artery. The anatomical knowledge of this artery and of the palatosphenoidal canal is of outmost importance in endoscopic transpterygoid and nasopharyngeal procedures, to identify the vidian canal, evaluate nasopharyngeal cancer spread in the pterygopalatine fossa, reduce bleeding during surgery of the nasopharynx, and harvest adequately the pedicle of the nasoseptal flap.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Azienda Ospedaliero Universitaria, Viale San Pietro 43, 07100, Sassari, Italy, alkis.karligkiotis@gmail.com.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Karligkiotis
authors.forename: Luca
authors.initials: L
authors.lastname: Volpi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Abbate
authors.forename: Paolo
authors.initials: P
authors.lastname: Battaglia
authors.forename: Francesco
authors.initials: F
authors.lastname: Meloni
authors.forename: Mario
authors.initials: M
authors.lastname: Turri-Zanoni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bignami
authors.forename: Paolo
authors.initials: P
authors.lastname: Castelnuovo
mesh_terms: D000368:Aged; D004724:Endoscopy / Q000379:methods*; D004844:Epistaxis / Q000175:diagnosis / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008438:Maxillary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D009305:Nasopharynx / Q000098:blood supply*; D011859:Radiography