Why is the perpendicular plate of the ethmoid and vomer removed during septoplasty?

Question

I had a septoplasty surgery and the perpendicular plate of the ethmoid and vomer were removed. If they are part of the anatomy of the cranium, they must perform some function. Was there removal necessary? Do they have nerves linked to other part of the head that can cause pressure headaches or other head sensations?

Stephen Prendiville, MD · Answer

When a septoplasty is performed, deviated portions of bone and or cartilage are removed.  The vomer is the lower of the septal bones, the perpendicular plate of the ethmoid the higher.  Since the perpendicular plate of the ethmoid is attached to the skull base, any incisions/cuts must be made sharply to prevent rocking of the skull base and subsequent CSF leak. Olfactory fibers are embedded in the superior portion of the nasal vault and should not be disturbed during a septoplasty.  The sensory portion of the septal mucosa remains intact. If you are experiencing headaches after a septoplasty, I recommend that you seek the opinion of your ENT Surgeon.

Sahar Nadimi, MD · Answer

A septoplasty is performed to address the septum of your nose – the piece of bone and cartilage that separates your right and left nostrils. The bony portion consists of the vomer and perpendicular plate of the ethmoid bone. This can be deviated towards one side and cause significant nasal obstruction. Often times, there are bony spurs that obstruct the airway and need to be carefully removed. The perpendicular plate of the ethmoid bone is attached to the skull base so care should always be taken when addressing any bony spurs. That being said, it is very common to resect portions of the bony septum in order to improve the airway. If you have any concerns, I recommend following up with your surgeon for an in-person exam. Best of luck!

Why is the perpendicular plate of the ethmoid and vomer removed during septoplasty?

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Why is the perpendicular plate of the ethmoid and vomer removed during septoplasty?

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Everything you need to know about Septoplasty

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