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Woodruff's plexus

Published online by Cambridge University Press:  21 February 2008

T W Chiu*
Affiliation:
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, China
J Shaw-Dunn
Affiliation:
Laboratory of Human Anatomy, University of Glasgow, Scotland, UK
G W McGarry
Affiliation:
Department of Otolaryngology, Glasgow Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr Tor Wo Chiu, Plastic Aesthetic and Reconstructive Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong, China. Fax: 852 26377974 E-mail: torchiu@surgery.cuhk.edu.hk

Abstract

Objective:

To identify the nature of Woodruff's plexus, which has been frequently mentioned in the rhinological literature but has never been properly characterised.

Study design and setting:

A study using 21 cadaveric specimens, combining microdissection of the mucosa of the posterior part of the inferior meatus, Spalteholz ‘clearing’ of specimens injected with latex ink, and histological analysis of sections of the inferior meatal mucosa.

Results:

Microdissection revealed a superficial plexus of thin walled vessels in the inferior meatus, which were also seen in cleared, injected specimens. Histological sections showed these vessels to be large, thin walled veins with very little muscle or fibrous tissue, within a thin mucosa relatively devoid of other structures.

Conclusion:

Woodruff's plexus is a venous plexus in the posterior part of the inferior meatus.

Significance:

This is the first time Woodruff's plexus has been properly characterised. Whilst the significance of the plexus itself is uncertain, its long overdue identification as a venous plexus provides a platform for further study and discussion.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Small, M, Maran, AGD. Epistaxis and arterial ligation. J Laryngol Otol 1984;98:281–4CrossRefGoogle ScholarPubMed
2 Josephson, GD, Godley, FA, Stierna, P. Practical management of epistaxis. Med Clin North Am 1991;75:1311–20CrossRefGoogle ScholarPubMed
3 Viducich, RA, Blanda, MP, Gerson, LW. Posterior epistaxis: clinical features and acute complications. Ann Emerg Med 1995;25:592–6CrossRefGoogle ScholarPubMed
4 Padgham, N. Epistaxis: anatomical and clinical correlates. J Laryngol Otol 1990;104:308–11CrossRefGoogle ScholarPubMed
5 Hallberg, OE. Severe nosebleed and its treatment. J Am Med Assoc 1952;148:355–60CrossRefGoogle ScholarPubMed
6 Jackson, KR, Jackson, RT. Factors associated with active refractory epistaxis. Arch Otolaryngol 1988;114:862–5CrossRefGoogle ScholarPubMed
7 Woodruff, GH. Cardiovascular epistaxis and the naso-nasopharyngeal plexus. Laryngoscope 1949;59:1238–42CrossRefGoogle ScholarPubMed
8 Lepore, ML. Epistaxis In: Bailey, BJ, ed. Head and Neck Surgery – Otolaryngology. Philadephia: Lippincott, 1993;428446Google Scholar
9 Watkinson, JC. Epistaxis. In: Kerr, AG, ed. Scott Brown's Otolaryngology; Rhinology, 6th edn. London: Butterworth 1997;4:119Google Scholar
10 Pearson, BW. Epistaxis: some observations on conservative management. J Laryngol Otol 1983;8(suppl):115–19Google ScholarPubMed
11 Wurman, LH, Sack, G, Flannery, JV, Paulson, TO. Selective endoscopic electrocautery for posterior epistaxis. Laryngoscope 1988;98:1348–9CrossRefGoogle ScholarPubMed
12 Thornton, MA, Mahesh, BN, Lang, J. Posterior epistaxis: identification of common bleeding sites. Laryngoscope 2005;115:588–90CrossRefGoogle ScholarPubMed
13 Shin, EJ, Murr, AH. Managing epistaxis. Curr Opin Otolaryngol Head Neck Surg 2000;8:3742CrossRefGoogle Scholar
14 Bishow, RM. Current approaches to the management of epistaxis. Journal of the American Academy of Physician Assistants 2003;16:5264Google Scholar
15 Pope, LER, Hobbs, CGL. Epistaxis: an update on current management. Postgrad Med J 2005;81:309–14CrossRefGoogle ScholarPubMed
16 Bancroft, JD, Stevens, A. Theory and Practice of Histological Techniques, 4th edn. Edinburgh: Churchill-Livingstone, 1995Google Scholar
17 Yanagisawa, E, Citardi, MJ. Telescopic view of Woodruff's naso-nasopharyngeal plexus. Ear Nose Throat J 1995;74:804–5CrossRefGoogle ScholarPubMed
18 Burnham, HH. An anatomical investigation of the blood vessels of the lateral nasal wall and their relation to turbinates and sinuses. J Laryngol Otol 1935;50:569–93CrossRefGoogle Scholar