Vomer

Anatomical structure

The vomer belongs to the facial bones of the skull. It is an unpaired bone that forms a vertical plate. It constitutes the posteroinferior part of the nasal septum.

In the basic study of osteology, no specific parts of the vomer are distinguished. The following terms are also found in educational Latin nomenclature:

• 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; it translates as "vomer" (plowshare).

How does the vomer articulate with other bones?

The vomer participates in forming fibrous joints of the skull—sutures (sutura).

A specific type of suture is called schindylesis (schindylesis). In the study guide, it is specified as the articulation between the vomer and the body of the sphenoid bone.

Clinical significance: congenital malformations

Impaired fusion of the maxillary processes with the vomer is indicated as the etiology of cleft palate (palatoschisis uranoschisis).

This pathology occurs with a frequency of 1 case per 1,000 newborns. Cleft palate results in communication between the oral and nasal cavities. The infant is unable to suckle, and milk flows into the nose. When combined with cleft lip, there is a severe impairment of sucking and breathing. Feeding is performed using a spoon or a special feeder.

Traumatology and surgery

In injuries to the upper jaw involving the destruction of the external nose, middle and superior nasal meatuses, surgical management includes the restoration of anatomy and function.

The tactics include:

• Careful removal of bone fragments, blood clots, and foreign bodies.
• Ensuring free drainage of wound discharge from the skull base to prevent basal meningitis.
• Mandatory checking for the presence or absence of cerebrospinal fluid leak.
• Inspection of the nasal meatuses and removal of non-viable tissues.
• Reduction of the nasal bones, vomer, and nasal conchae.
• Checking the patency of the nasal passages.
• Insertion of polyvinyl or rubber tubes wrapped in 2–3 layers of gauze into the nasal passages to their full depth up to the choanae. Functions of the tubes: fixation of the preserved mucosa, provision of nasal breathing, prevention of cicatricial narrowing in the postoperative period.

Nomatous process

In the nomatous process, combined necrosis of the upper lip and tissues of the nasal base—including the alae nasi, other parts of the external nose, and the septum—is most frequently observed.

The process may extend to the nasal septum and vomer. Early plastic corrective surgeries are contraindicated due to the child's extreme exhaustion and high risk of wound healing complications.

Localization statistics for the nomatous process involving the upper jaw indicate: upper jaw — 54% of cases; of these, the body and/or alveolar process account for 92%, and the incisive bone and vomer account for 8%.

Class and exam questions

What else to study on this topic

• Bones of the viscerocranium
• Classification of bone joints: skull sutures
• Congenital malformations: cleft palate
• Nomatous process

Other topics in the "Anatomical Structures" section

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.