**Core Concept**
Hereditary hemotelangiectasis, also known as Osler-Weber-Rendu syndrome, is a genetic disorder characterized by the formation of multiple telangiectasias and arteriovenous malformations, leading to recurrent nosebleeds (epistaxis) and other complications.

**Why the Correct Answer is Right**
The treatment of choice in recurrent epistaxis in a patient with hereditary hemotelangiectasis typically involves endovascular embolization or selective arterial embolization of the affected branch of the external carotid artery, which helps to reduce blood flow to the telangiectasias and prevent further bleeding. This procedure is usually performed by an interventional radiologist or a vascular surgeon.

**Why Each Wrong Option is Incorrect**
**Option A:** Topical nasal packing is often used to control acute epistaxis but is not a long-term solution for recurrent epistaxis in hereditary hemotelangiectasis.
**Option B:** Antifibrinolytic agents, such as tranexamic acid, may be used to reduce bleeding in patients with hereditary hemotelangiectasis, but they are not the treatment of choice for recurrent epistaxis.
**Option C:** Surgical ligation of the external carotid artery can be considered in some cases, but it is not the preferred treatment for recurrent epistaxis in hereditary hemotelangiectasis due to the risk of complications.

**Clinical Pearl / High-Yield Fact**
Hereditary hemotelangiectasis is often associated with other systemic manifestations, including gastrointestinal bleeding, pulmonary telangiectasias, and central nervous system involvement. A high index of suspicion is essential for diagnosing this condition, and a multidisciplinary approach is often required for management.

**Correct Answer:** C. Selective arterial embolization.