Vomer Agenesis as a Rare Cause of Hypernasality

Abstract

Hypernasality which is rare symptom commonly occur as a consequence of velopharyngeal insufficiency (VPI). VPI usually manifested as nasal air emission and hypernasal resonance during speech. The cause can be divided into congenital, neuromuscular disorder and surgical complication. Congenital cause of VPI includes cleft palate, nasal septum malformation such as vomer agenesis, submucous cleft palate and velar dysplasia, while neuromuscular VPI can be due to cerebral palsy or cerebrovascular accident. Surgical cause of VPI could be due to adenoidectomy and scarring of the velum post palatoplasty in cleft palate repair. We present a 17-year-old man who was diagnosed of congenital left nasolacrimal duct obstruction referred to us for left endoscopic dacrocystorhinostomyin which during nasoendoscopic examination revealed absence of vomer.

The complete anatomy of the lingual nerve: A meta‐analysis with implications for oral and maxillofacial surgery

“…The other frequent cause of LN injury is a trauma‐induced injury to the nerve during the administration of anesthesia, such as during the IAN blocks (Garisto et al, 2010; Tan et al, 2014). Other causes of possible nerve damage include procedures such as the excision of neoplastic lesions (Behnia et al, 2000), periodontal and periprosthetic operations (Hunt, 1976; Mozsary & Middleton, 1984; Reinhart et al, 1990), ductoplasty and removal of sialoliths, orthognathic surgeries such as a sagittal split osteotomy (Al‐Bishri et al, 2004; Guernsey & DeChamplain, 1971; Jacks et al, 1998; Mosleh et al, 2016), vestibuloplasty (de Koomen, 1977), submental endotracheal intubation (de Toledo et al, 2013), and suspended laryngoscopy (Gaut & Williams, 2000; Mohamad & Mohamad, 2012; Teichner, 1971). The tongue retractor used by oral surgeons during intraoral procedures has also been implicated in causing LN compression (Teichner, 1971).…”

Evaluation of Cribriform Plate Dimensions and Middle Turbinate Length in Patients With Vomeral Agenesis: A Computed Tomography Study

“…Septoplasty and/or endoscopic sinus surgery (ESS) can be planned for patients with VA for various indications. 4,5 One of the most severe complications of ESS and/or septoplasty is fracture of the CP, which may lead to dura mater and bone defects resulting in various complications such as cerebrospinal fluid (CSF) fistula, CSF rhinorrhea, ascending meningitis, intracranial hypotension from CSF leak, meningocele, and meningoencephalocele. 6,7 Therefore, possible associations between VA and CP should be investigated.…”