Vomer
Vomer
location_on Midline of the nasal cavity, forming the posteroinferior nasal septum
The vomer is a thin, flat, unpaired bone forming the posteroinferior portion of the nasal septum. Shaped like a plowshare (its Latin namesake), it extends from the sphenoid bone superiorly to the hard palate inferiorly. It is one of the few unpaired bones in the skull and, along with the perpendicular plate of the ethmoid and the septal cartilage, divides the nasal cavity into left and right halves.
Key Anatomical Features
- Alae (wings) spread superiorly to articulate with the sphenoid body
- Anterior border articulates with the perpendicular plate of ethmoid and septal cartilage
- Posterior border is the free edge that separates the posterior nasal apertures (choanae)
- Nasopalatine groove on the lateral surface carries the nasopalatine nerve and vessels
- Inferior border rests on the nasal crest of the maxillae and palatine bones
Muscle Attachments
| Muscle | Attachment | Action |
|---|---|---|
| No direct muscular attachments | The vomer is a purely structural bone | Divides the nasal cavity into left and right halves |
| Nasal septum mucosa | Covers both surfaces | Warms, humidifies, and filters inspired air |
| Vomeronasal organ (vestigial) | Anteroinferior vomer near the septal cartilage | Non-functional in humans but detects pheromones in other species |
| Pharyngeal aponeurosis (indirect) | Near posterior free edge | Supports nasopharyngeal structures |
Joints and Articulations
| Joint | Type | Connects to |
|---|---|---|
| Vomerosphenoidal junction | Fibrous suture (schindylesis) | Sphenoid bone |
| Vomerine-ethmoidal junction | Fibrous suture | Perpendicular plate of ethmoid |
| Vomero-palatine suture | Fibrous suture | Palatine bone |
Common Pathologies
Deviated nasal septum
The vomer frequently contributes to septal deviation, which can obstruct nasal airflow and cause chronic sinusitis. Present to some degree in up to 80% of the population.
Septal perforation
A hole through the nasal septum including the vomer can result from trauma, cocaine use, prior surgery, or granulomatous diseases like granulomatosis with polyangiitis.
Vomer fracture
Usually accompanies midface fractures. Isolated vomer fractures are rare but can cause septal hematoma and subsequent cartilage necrosis.
Clinical Relevance
The vomer is a key structure in septoplasty surgery for deviated septum correction. The nasopalatine nerve and sphenopalatine artery run along the vomer and are important sources of epistaxis (nosebleed). The posterior free edge of the vomer defines the boundary of the choanae, critical landmarks in assessing for choanal atresia in neonates.
Development and Ossification
The vomer ossifies intramembranously from two lateral centers that appear around the 8th fetal week and fuse to form a single midline bone. It is one of the first facial bones to begin ossification.
Did You Know?
- Vomer means plowshare in Latin, named for its resemblance to the blade of a plow
- The vomeronasal organ on the vomer detects pheromones in most mammals but is considered non-functional in humans
- The vomer articulates with six bones: sphenoid, ethmoid, both maxillae, and both palatine bones
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