Abstract: Objective To explore the the pathogenesis, characteristics, diagnosis and treatment of severe nasal bleeding caused by traumatic injury of the internal carotid artery. Method The clinical data of 12 cases were retrospectively analyzed. Result Of the 12 cases, 6 cases underwent nasal endoscopy and were found beating bleeding at the submucosal lateral nasal wall, then were treated by the Caldwell Luc approach to stop bleeding, meanwhile 4 cases of them were treated by maxillary fracture and zygomatic fracture reduction and titanium plate internal fixation. Another 6 cases were made definite diagnosis with digital subtraction angiography(DSA)and were treated by parallel vascular embolization. Conclusion As for patients with maxillofacial injury with repeated nasal hemorrhage, they should be considered and treated by nasal endoscopy and/or DSA examination and embolization. If embolization is too late in the process of nasal endoscopy bleeding, ligation or electric coagulation could be performed out by the Caldwell Luc approach, also iodoform gauze could be used for stuffing. After stopped bleeding, maxillofacial fracture reduction and internal fixation should be done.

Key words: Epitaxis, Embolization, Internal carotid artery, Digital subtraction angiography