Vomer Agenesis as a Rare Cause of Hypernasality

Hypernasality which is a rare symptom commonly occurs 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. The 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 with congenital left nasolacrimal duct obstruction referred to us for left endoscopic dacryocystorhinostomy in which during nasoendoscopic examination revealed the absence of vomer.