Inclusive Anatomy
Historical Timeline
1800
1879
Present
1871
1884
Carl Michel
Carl Michel identified the vascular plexus in the anterior part of the nasal septum as a common source of nasal bleeding. These findings were published in his book, Diseases of the Nasal Cavity: And the Vault of the Pharynx.[4]
James Lawrence
In an article published in The Hospital Gazette, surgeon James Lawrence Little wrote a piece entitled A Hitherto Undescribed Lesion As a Cause of Epitaxis with Four Cases, wherein he described the vascular network in the anterior inferior part of the nasal septum. His focus was on its clinical importance, particularly its predisposition to anterior epistaxis.[5]
Wilhelm Kiesselbach
Wilhelm Kiesselbach later provided detailed anatomical descriptions in his paper, On Spontaneous Nosebleeds, further emphasizing the dense vascular confluence in this region. Kiesselbach's publishing of this paper led to the common usage of “Kiesselbach plexus” to describe this source of epistaxis, eventually leading to the wider adoption of the eponym, which became commonplace in medical literature by the 20th century.[4,5]
Eponym:
The anterior inferior part of the nasal septum is eponymously referred to as Kiesselbach’s plexus, named after the German otolaryngologist Wilhelm Kiesselbach (1839–1902). Kiesselbach was born in Hanau, Germany, and pursued his medical education at the Universities of Göttingen, Marburg, and Tübingen.[1] After earning his doctorate in 1875, he qualified as a professor of otolaryngology in 1879 and began teaching at the University of Erlangen in 1881. He later served as an associate professor of otology and held senior clinical positions in Vienna.[1,2]
Kiesselbach is best known for his meticulous anatomical and clinical studies of nasal bleeding. In his 1884 publication, On Spontaneous Nosebleeds, he emphasized the clinical significance of the dense arterial network in the anterior nasal septum and identified it as the most frequent source of epistaxis.[3] His work firmly established the anatomical and clinical relevance of this region.
Wilhelm Kiesselbach - Image Obtained From: Library of Congress / Harris & Ewing Collection (Public Domain)
Scientific Contribution:
Wilhelm Kiesselbach made important contributions to the early development of rhinology through his detailed anatomical and clinical investigations of nasal bleeding. His work helped clarify the vascular organization of the anterior nasal septum and emphasized the clinical significance of this region as the most common source of anterior epistaxis. By correlating anatomical observations with clinical presentation, Kiesselbach provided physicians with a clearer understanding of why nosebleeds frequently originate from this specific area of the nasal cavity.[3]
Kiesselbach's 1884 publication on spontaneous nosebleeds expanded upon earlier observations by Carl Michel and James Lawrence Little by offering a more comprehensive anatomical description of the arterial anastomoses within the anterior septum. His work reinforced the concept that multiple arterial branches, including contributions from the sphenopalatine, anterior ethmoidal, greater palatine, and superior labial arteries, converge within this region, forming a vascular plexus highly susceptible to bleeding.[4,5]
Although Kiesselbach was not the first to recognize this vascular network, his systematic anatomical description and emphasis on its clinical relevance led to widespread adoption of the eponym "Kiesselbach's Plexus". His work helped standardize the anatomical understanding of anterior epistaxis and contributed to improved diagnostic and therapeutic approaches in otolarynology.[4,5]
References
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Efrain MA. Wilhelm Kiesselbach. www.clinicalanatomy.com. https://www.clinicalanatomy.com/mtd1/865-wilhelm-kiesselbach
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Lexikoneintrag zu »Wilhelm Kiesselbach«. Pagel: Biographisches Lexikon hervorragender ... Accessed January 18, 2025. http://www.zeno.org/Pagel-1901/A/Kiesselbach,+Wilhelm
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Berliner Klinische Wochenschrift 1885 22. http://archive.org/details/BerlinerKlinischeWochenschrift188522
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Dubel GJ, Ahn SH, Soares GM. Transcatheter embolization in the management of epistaxis. Semin Intervent Radiol. 2013;30(3):249-262. doi:10.1055/s-0033-1353478
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Rainey JJ. James Lawrence Little, A Forgotten Pioneer. AMA Archives of Otolaryngology. 1952;55(4):451-452. doi:10.1001/archotol.1952.00710010463007
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