Vomer bone graft to augment the deficient cleft maxilla

Patients with clefts of the lip and palate commonly develop maxillary hypoplasia. In addition to orthognathic surgery, augmentation of the anterior maxilla may be necessary in these patients to restore symmetry to the nasomaxillary complex. Bone graft may be obtained from numerous sites. All require a separate incision at the donor site and may result in additional morbidity.The authors describe a 16-year-old with a complete right unilateral cleft of the lip and palate who underwent maxillary advancement at the Le Fort I level. Pronounced sagittal deficiency of the maxilla necessitated osseous augmentation. The patient's deformity resulted in deviation of the superior vomer bone. This bone was of adequate quality to be used as an onlay graft for the maxilla. This is the first report documenting the use of vomer as a bone graft for maxillary augmentation.