Anatomic Structure
The vomer is classified as a facial bone. It is an unpaired, vertically oriented bony plate that forms the posterior and inferior portions of the nasal septum.
In standard osteology, the vomer itself has no formally subdivided parts, but closely associated structures and Latin terminology include:
- Wing of vomer (ala vomĕris)
- Vomerine groove (sulcus vomĕris)
- Vomeronasal cartilage (cartilāgo vomeronasālis)
Grammar note: The Latin term vomer, ĕris m is a masculine noun translating to "plowshare" or vomer.
Articulations of the Vomer
The vomer participates in fibrous joints of the skull known as sutures (suturae).
A specific type of suture is schindylesis (schindylesis), characterized by a plate of bone fitting into a cleft or fissure of another bone. Specifically, this describes the articulation between the vomer and the rostrum/body of the sphenoid bone.
Clinical Significance: Congenital Anomalies
Failure of the maxillary processes to fuse properly with the vomer is implicated in the etiology of cleft palate (palatoschisis / uranoschisis).
This congenital anomaly occurs with an incidence of approximately 1 in 1,000 newborns. Cleft palate creates an abnormal opening between the oral and nasal cavities, leading to feeding difficulties such as an inability to generate suction, causing milk to regurgitate through the nose. When combined with a cleft lip, both suckling and breathing are severely impaired, requiring specialized feeding methods such as a spoon or a feeder bottle.
Traumatology and Surgery
Maxillary trauma involving destruction of the external nose, middle, and superior nasal meatuses requires prompt surgical management to restore anatomy and function.
Surgical tactics include:
- Gentle removal of bone fragments, blood clots, and foreign bodies.
- Ensuring free drainage of wound discharge away from the cranial base to prevent basal meningitis.
- Screening for the presence or absence of cerebrospinal fluid leak (rhinorrhea).
- Exploration of the nasal passages and debridement of non-viable tissues.
- Reduction of the nasal bones, vomer, and nasal conchae.
- Verification of nasal passage patency.
- Insertion of polyvinyl chloride or rubber tubes wrapped in 2–3 layers of gauze extending deep into the choanae. These tubes serve multiple functions: fixing the preserved mucosa, maintaining nasal breathing, and preventing post-operative cicatricial stenosis.
Noma (Cancrum Oris)
In noma (cancrum oris), the process most frequently manifests as combined necrosis of the upper lip and tissues of the nasal base, including the alae, other regions of the external nose, and the septum.
The necrotic process can extend directly to the nasal septum and the vomer. Early plastic reconstructive surgery is contraindicated due to severe patient debilitation and high risks of wound healing complications.
Statistical data regarding localization in maxillary noma indicate: maxilla involvement in 54% of cases; among these, the body and/or alveolar process accounts for 92%, while the incisive bone and vomer account for 8%.