Abstract: Objective: To investigate the common nasal bleeding points and the management for intractable epistaxis. Methods: The bleeding points, surgical techniques and the curative effect were studied retrospectively in 68 patients, in whom the hemorrhage was not controlled with standard nasal packing. Results: The bleeding points were found in the following different sites: superior wall of inferior nasal meatus, 27.9% (19/68); olfactory cleft of nasal septum, 20.7% (14/68); posterosuperior wall of middle nasal meatus, 16.1% (11/68); sphenopalatine artery zone of posterior middle turbinate, 10.3%（7/68）; posterior of nasal septum, 10.3%（7/68）; superior wall of nasopharynx, 5.9%（4/68）; Woodruff venous plexus, 4.4% (3/68) and the uncertain, 4.4% (3/68). Epistaxis was well controlled in 65 cases by electrocoagulation, and in 3 cases by gelfoam packing. There were no complications during a followup for 1  3 months. Among the 68 patients, bleeding was stopped in 59 ( 86.7%) after once treatment, while in 9 cases(13.3%) after twice. Conclusion: Endoscopy provides an effective and safe way to visualize and manage the deeplysited bleeding points.

Key words: Endoscopy, Electrocoagulation, Epistaxis, Treatment outcome