Fivehundredsixtythree patients were admitted for inpatient management of epistaxis over a two-year period. Ten of these patients required surgical control of epistaxis and went on to have either sphenopalatine

* Received for publication: December 3, 2001; accepted: May 10, 2002 INTRODUCTION Epistaxis is the commonest nasal emergency requiring hospital admission (Small and Maran, 1984). Its prevalence in the population is estimated to be between 10–12% (Shaheen, 1967), of which 10% seek medical attention (Ram et al., 2000). Of these, 1% will require surgery (Ram et al., 2000). Traditionally, epistaxis was treated with nasal packing initially. This was done with anterior gauze (BIPP/Vasolene) packs and or Foley/Brighton intranasal balloons. Arterial ligation or embolization is then the second/last resort. This traditionally used to involve internal maxillary artery ligation via a Caldwell–Luc approach or ligating the external carotid artery in the neck (Pritikin et al., 1998). However recently ligation of the sphenopalatine artery endoscopically endonasally, as the most distal feeding vessel to the nose posteriorly (Sharp et al., 1997), has become a logical, effective (Shaheen, 1975) and more frequently done intermediary step. In 1976, Prades described the ligation of the sphenopalatine artery using the operating microscope, to control bleeding in his approach to the Vidian nerve (Prades, 1976). In 1987, microscopic clipping of the artery for recurrent epistaxis was described (Sulsenti et al., 1987) and in 1988 endoscopic electrocautery was described by Wurman et al. for posterior epistaxis (Wurman et al., 1988). The use of the endoscope in FESS has meant that virtually every department in the UK has the potential to attempt to ligate the sphenopalatine artery. We audited our unit's ability to do just this.