{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:24:56Z","timestamp":1792841096631,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The previously described S\u2010point, corresponds to the medial projection of the middle turbinate axilla in the superior nasal septum and has been identified as a common source of severe epistaxis. The objective is to define the anatomical patterns of vascularization of the S\u2010point area that could explain its clinical relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010three nasal septums of latex\u2010injected formalin\u2010embalmed and fresh human cadaveric heads were dissected to analyze the arterial arrangement of the S\u2010point area. Measurements and patterns of vascularization were described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The S\u2010point area, was consistently surrounded by a single or multiple arterial anastomotic arches consistently formed superiorly by the anterior ethmoidal and posterior ethmoidal artery branches, and inferiorly by the posterior septal artery. The caliber of the arterial arches was typically larger than the caliber of the arterial branches supplying them. A single arch was present in 36.3% of septums, and multiple arches in 63.6%. The mean distance from the S\u2010point to the anterior limit of the arch was 9\u2009mm, to the posterior arch when the present was 3\u2009mm, to the superior limit 6\u2009mm, to the inferior limit 6\u2009mm, and to the nasal roof was 10\u2009mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates the dense arterial configuration of the S point area, which is characterized by a single or multiple vascular arches of greater caliber than the branches of origin. This finding could explain why the S\u2010point area is a frequent source of epistaxis, and guide its surgical cauterization when an obvious vascular ectasia is not visualized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      N\/A\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 133:2075\u20132080, 2023\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.30487","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T07:33:43Z","timestamp":1668584023000},"page":"2075-2080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Arterial Pattern of the Upper Nasal Septum (S\u2010Point) and Potential Role in Severe Epistaxis"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2568-6099","authenticated-orcid":false,"given":"Nat\u00e1lia Cerqueira","family":"Rezende","sequence":"first","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Neurologic Surgery Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Federal University of Sao Paulo (UNIFESP\u2010EPM)  Sao Paulo Brazil"},{"name":"Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8066-4055","authenticated-orcid":false,"given":"Luciano C.P.C.","family":"Leonel","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery Mayo Clinic  Rochester Minnesota 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Anatomy Program Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9189-303X","authenticated-orcid":false,"given":"Maria","family":"Peris\u2010Celda","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Skull Base Surgery, Department of Otolaryngology \u2013 Head &amp; Neck Surgery Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Neurologic Surgery Mayo Clinic  Rochester Minnesota USA"},{"name":"Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program Mayo Clinic  Rochester Minnesota 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