What is Little’s area or Kiesselbach’s area and the Arteries in it

Definition: Kiesselbach’s area or plexus is an anastomosis of five blood vessels in the anterior inferior quadrant of the nasal septum over the septal cartilage. 

Synonyms: Kiesselbach’s plexus, Kiesselbach’s area, Kiesselbach’s Triangle, Little’s Area

The anterior inferior part of nasal septum Contains anastomoses between the superior labial branch of facial artery and sphenopalatine artery, and anterior ethmoidal artery, apart from a large capillary network. This large capillary network is called the kiesselbach’s plexus or triangle. This is a common site of bleeding from nose(Epistaxis) and is known as little’s area or kiesselbach’s area.

Littles area or Kiesselbach plexus

Kiesselbachs plexus is the anastomos of five arteries:

Sphenopalatine artery after branching from the maxillary artery enters the nasal cavity through the foramen-sphenopalatinum sphenopalatine foramen to supply the septal wall of the cavity

Greater palatine artery after branching (terminal branch) from the maxillary artery passes through the  greater palatine foramen and travels along thehard-palate to enter the nasal cavity through the incisive canal joining the anastomosis in Kiesselbach’s area

Superior labial artery branches from the facial artery, the septal branch of superior labial arteryenters the nasal cavity through the nares and joins the anastomoses in Little’s area

Anterior ethmoidal arteries after entering through the orbit supply to the roof as well as the septal wall of the cavity as it travels to Little’s area

Lateral nasal branches of facial artery

Kiesselbach’s or Little’s area is a common site of epistaxis (nose bleeds) in both paediatric (children) and adult cases because of the dense blood supply in this area.

Nose Bleeds or Epistaxis in relation to Little’s Area or Kiesselbach’s Area:

Epistaxis or Nose Bleeds seen in 90% of the cases is due to an injury to the Anterior Nasal cavity which includes the Anterior Nasal septum or the Little’s area. The Greater palatine artery and the Septal branch of superior labial artery enter into the nasals septum making a 90 degree turn to form the Littles area emerging from the floor of the nasal cavity. Little’s area therefore is predominantly supplied by the septal branch of the superior labial artery and inferior septal branches of the sphenopalatine artery. 

Due to the high density of the blood supply in the area, any small injury or trauma along with conditions like Sinusitis, secondary hemorrhages after surgery etc can be causes of bleeding through the nose. In most cases of Bleeding through nose, Littles area is the origin of the blood. 

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