Vomer bone graft to augment the deficient cleft maxilla

Area of Science:

• Craniofacial Surgery
• Oral and Maxillofacial Surgery
• Plastic Surgery

Background:

• Maxillary hypoplasia is a common complication in patients with cleft lip and palate.
• Surgical correction often involves maxillary advancement and augmentation to restore nasomaxillary complex symmetry.
• Traditional bone grafting methods require separate donor sites, potentially increasing patient morbidity.

Observation:

• A 16-year-old patient with a complete right unilateral cleft lip and palate presented with significant sagittal maxillary deficiency.
• The patient underwent Le Fort I maxillary advancement.
• The superior vomer bone, deviated due to the deformity, was utilized as an onlay bone graft for maxillary augmentation.

Findings:

• The vomer bone was successfully harvested and used as an autograft for maxillary augmentation.
• This represents the first documented use of the vomer bone for this purpose.
• The onlay graft effectively augmented the anterior maxilla, contributing to improved symmetry.

Implications:

• The vomer bone offers a viable alternative autograft source for maxillary augmentation in cleft patients.
• Utilizing the vomer bone may reduce the need for extraoral donor sites, thereby minimizing surgical morbidity.
• This technique expands the options for reconstructive surgery in patients with cleft lip and palate deformities.