Cleft palate and harelip.

Date:
1908
Catalogue details

Licence: Public Domain Mark

Credit: Cleft palate and harelip. Source: Wellcome Collection.

Provider: This material has been provided by the University of Toronto, Harry A Abbott Dentistry Library, through the Medical Heritage Library. The original may be consulted at the Harry A Abbott Dentistry Library, University of Toronto.

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    now packed up under the lip to clieck hemorrhage, and one approxi- mates the imcut margins of the cleft in the lip to estimate the extent it may be necessary to denude the edges. It is very necessary to estimate carefully the amount of vermillion border available, and in most cases it is well to have the edges at the newly-formed junction pout a little to allow for the contraction of the scar. I have succeeded on more than one occasion in presenting the mother with a child with a veritable Cupid's bow of a mouth in exchange for the distressing monstrosity that came to the Children's Hospital. On several occasions mothers have been loath to believe that they were getting their own child back again. Besides getting over all possibility of tension by undermining extensively, there is another advantage that I must mention, namely, the exudation that takes place in the face is sufficient to make the face absolutely rigid, so that if the child cries there is no movement whatever of the upper lip, and therefore, even if the child were to cry day and night, there would be no possibility of the lip being pulled apart In cases of double harelip with a projecting premaxilla, the lip should be freed from the premaxilla, and this bone used to fill in the space in the alveolar margin before the lip is dealt with. The small portion of skin attached to the premaxilla may then be utilized in the repair of tlie lip. After operation it is well to keep the lower lip retracted and the lower jaw depressed for a few days by a piece of adhesive plaster, lest the child, accustomed to a large space for respiration, becomes suffocated before it has learned the use of its new nasal cavity. It is well, too, after all such operations, to apply to the arms some light splint sufficient to prevent flexion of the elbow-joint and thus prevent the child's hands reaching the site of operation with perhaps disastrous results. BIBLIOGEAPHY. ^Arthur Keith, Human Embryology and Morphology. *Von Bergmann's System of Practical Surgery, vol. 1, page 457. •Treves' System of Surgery, vol. 2, page 465. * Cheyne and Burghard, Manual of Surgical Treatment, part 5, page 162. * Cleft Palate and Harelip, W. Arbuthnot Lane,—A Monograph. * New Method of Dealing with Cleft Palate, F. N. G. Starr, British Medical Jownal, June 29th, 1907.