XII. Operative Treatment of Cleft Palate

John E. MacKenty
1915 Annals of Otology, Rhinology and Laryngology  
In presenting this subject, I am well aware that a small library would not contain the mass of literature at present surrounding it. My apology is that, of necessity, every operator in this discouraging field must view it from a slightly different angle, and thus may add an idea or two to its betterment. That so few surgeons are actively interested in the correction of this deformity may be due to the feeling that the last word has been said; that the operative treatment has reached its limit
more » ... reached its limit of perfection, and withal a large percentage of failure remains-not so much cosmetic, perhaps, as functional. For, in spite of a well accomplished operation, correct speech does not always follow. This latter failure is not so evident among the well-to-do as in the poorer classes, from which a very large percentage of our cleft palates come. It sometimes takes years of persistent teaching to make the surgically cured palate functionate, and the uneducated poor have 110t the intelligence, the time or the money to follow this course of training. Then, there are the cases living in the country districts. where proper training is not available. My experience convinces me that the percentage of speech failure is rnucli larger than that of surgical failure. In my cases operated on after the tenth year, speech improvement in many cases was negative. Where the Lane operation was done, or where there was much cicatrization and contraction of the soft palate, speech was but slightly improved at any age. Nor can I see much hope for such cases in that direction. Where operation was done at an early age (in the first or second year), and the soft palate was carefully preserved intact, I have had
doi:10.1177/000348941502400112 fatcat:v6cyd5blbnaspgagfwzofvgfyi