Posterior epistaxis is harder to manage because it originates from which plexus?

• A. Kiesselbach plexus
• B. Woodruff plexus
• C. Sphenopalatine artery
• D. Inferior turbinate

Answer: (B)

Posterior epistaxis is harder to control because it comes from Woodruff's plexus, a venous-plexus located high on the posterior nasal cavity along the posterior lateral wall. This deep location means bleeding can be brisk and harder to visualize, and it often involves larger vessels branching from the sphenopalatine artery. Because the source is distant from the nostril, simple anterior packing is less effective, and management often requires more advanced measures such as posterior nasal packing, endoscopic cauterization, or surgical/arterial interventions.

Kiesselbach's plexus is on the anterior nasal septum and is the typical source of easier-to-treat, anterior bleeds. The inferior turbinate is a structure, not the source of a bleed, and the sphenopalatine artery is a vessel feeding the area rather than a plexus itself.