A case series of the greater palatine foramen injection with epinephrine as an adjunctive treatment for epistaxis.

Epistaxis is a worldwide problem with numerous proposed treatment algorithms, many of which end with nasal packing. Avoidance of packing, given its' known complications, is a reasonable goal.3,6 Therefore, we present several cases demonstrating the greater palatine foramen injection with epinephrine as an option for epistaxis management. The greater palatine foramen, located in the posterolateral hard palate intra-orally, gives rise to the greater palatine artery. This artery courses through the incisive foramen to the nasal septum and Kiesselbach's plexus. Anesthetizing it has been done for years to achieve dental anesthesia. Repurposing this procedure to control operative bleeding has been described in otolaryngology literature.5 Therefore, it is sensible to consider it for epistaxis management. Given the complications associated with nasal packing and patient discomfort with the procedure, it is reasonable to investigate additional treatment options for epistaxis; and; therefore, the greater palatine foramen injection may be appropriate for study in a prospective manner.