Woodruff's plexus
Woodruff's plexus was discovered by George H. Woodruff in 1949. The plexus is located below the posterior end of the inferior concha, on the lateral wall of the nasal cavity.{{cite journal |last1=Woodruff |first1=GH |title=Cardiovascular epistaxis and the naso-nasopharyngeal plexus. |journal=The Laryngoscope |date=November 1949 |volume=59 |issue=11 |pages=1238–47 |doi=10.1288/00005537-194911000-00003 |pmid=15394264|s2cid=43177792 }}{{cite book|editor-last1=Gleeson|editor-first1=Michael|title=Scott-Brown's otolaryngology, head and neck surgery|date=2008|publisher=Hodder Arnold|location=London|isbn=978-0340808931|edition=7th}}{{Cite web|url=https://radiopaedia.org/articles/woodruff-plexus?lang=gb|title=Woodruff plexus|website=radiopaedia.org|access-date=18 July 2019}} He described it as the naso-nasopharyngeal plexus.
Structure
Woodruff's plexus is located on the lateral wall of the nasal cavity below the posterior end of the inferior nasal concha (turbinate). The plexus contains both arteries and veins which lie in a thin mucosa.{{cite journal |last1=Chiu |first1=TW |last2=Shaw-Dunn |first2=J |last3=McGarry |first3=GW |title=Woodruff's plexus. |journal=The Journal of Laryngology and Otology |date=October 2008 |volume=122 |issue=10 |pages=1074–7 |doi=10.1017/S002221510800176X |pmid=18289456|s2cid=2866097 }} The major arteries supplying the plexus are the sphenopalatine artery and ascending pharyngeal artery.{{Cite web |title=Epistaxis {{!}} Iowa Head and Neck Protocols |url=https://medicine.uiowa.edu/iowaprotocols/epistaxis |access-date=2025-02-06 |website=medicine.uiowa.edu}} The internal maxillary vein is also within the plexus.
Clinical significance
= Bleeding =
A nosebleed (epistaxis) usually occurs in the anterior part of the nose from an area known as Kiesselbach's plexus which consists of arteries. Woodruff's plexus is a venous plexus in the posterior part and a nosebleed here accounts for only between 5 and 10 per cent of nosebleeds. Older adults are most often affected.{{cite book|editor-last1=Seiden|editor-first1=Allen M.|title=Otolaryngology : the essentials|date=2002|publisher=Thieme|location=New York [u.a.]|isbn=9780865778542|edition=1st}}
| class="wikitable"
|+Risk factors for nosebleed in Woodruff's plexus !Local !Systemic |
* Trauma
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{{cite journal |url=http://www.aafp.org/afp/20050115/305.html |title=Management of Epistaxis |journal=American Family Physician |volume=71 |issue=2 |pages=305–311 |author1=Corry J. Kucik |author2=Timothy Clenney |date=January 15, 2005 |accessdate=18 July 2019 |publisher=American Academy of Family Physicians |pmid=15686301 |archive-date=29 August 2008 |archive-url=https://web.archive.org/web/20080829203041/http://www.aafp.org/afp/20050115/305.html |url-status=dead }}
= Treatment =
Posterior nasal packing is needed for posterior epistaxis.