Greater palatine canal injection: an alternative to the posterior nasal packing and arterial ligation in epistaxis.

The greater palatine foramen extends in a posterosuperior direction at an angle of 60-80 degrees from the horizontal plane of the hard palate. A needle can be inserted 22-25 mm without the risk of intracranial or intraorbital injection. Sixty-one patients with posterior epistaxis were treated by greater palatine canal injection of either xylocaine 1% without epinephrine (34 cases) or sterile water (27 cases). There were no serious complications. Effective hemostasis was obtained immediately in 55 cases. Recurrent bleeding occurred in 22 cases, all of which responded to repeat injections.