Report of a Successful Operation for Cleft Palate

1857 Boston Medical and Surgical Journal  
Staphylorapiiy, or the operation for the cure of cleft palate, lias received much attention from modern surgeons. The operation is one of importance, both on account of the peculiar nature of the mal for niation it proposes to correct, and the numerous difficulties attending flic performance of tho operation itself. The following case, it is thought, will lie of interest in connection with this subject generally-though more specially in reference to a novel mode of performing an important part
more » ... an important part of tho operation, which lias boon recently introduced to notice by an English surgeon, Mr. Pollock. The common cause of failure in this operation is well known, among surgeons, to be the dragging on the sutures, produced by the involuntary contractions of the palate, during and subsequent to the operation;-and it is generally conceded that in order to perform tho operation easily, as avcII as to effect the nice adjustment of parts requisite to secure a complete and firm union throughout, it is necessary to paralyze the velum palali by a division of tho muscular structures which produce these spasmodic movements. The muscle chiefly active in producing the movements prejudicial to tho success of this operation, is the levator palali ; and a complete division of this muscle, if not absolutely essential, is certainly very favorable to a successful result. To lesscu the chances of inflammation, it is very desirable to cut the parts involved as little as possible. The " lateral incisions " of Dieffenbach are open to this objection of mutilation ; and so also are random incisions about the pillars of the fauces. The point at Avhich tho levator can be divided with tho least cutting is at the base of the hamular process of the sphenoid bone. Tho manner in Avhich this point can be easily reached, is shown in tho following account of an operation recently performed by me.
doi:10.1056/nejm185706110561901 fatcat:tgqhiwvkqbb6fi3qftfbjhsu5e