Observations on cleft palate and on staphyloraphy / by W. Fergusson.

  • Fergusson, William.
Date:
[1845]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on cleft palate and on staphyloraphy / by W. Fergusson. Source: Wellcome Collection.

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    this proposition is still more apparent, especially if the malformation extends through the alveoli, for then the surfaces of the hard palate slope upwards like the two sides of a triangle, and nearly join in the floor of the nostril. Few have had the opportunity of dissecting a cleft palate, and some notice of a specimen in my possession will form an appropriate introduc¬ tion to the views developed in this paper. The fissure in this instance implicates a portion of the hard as well as the whole soft palate, and is such as the surgeon frequently meets with in practice. The specimer was procured in the dissecting - room from the mouth of an afl^d female subject. In the examination of this preparation there are several marked difi ferences between it and the parts in a more natural state. The superior constrictor muscle is more fully developed than under ordinary circum¬ stances, and its upper margin, extending between the basilar process of the occipital bone and the internal pterygoid plate, is particularly dis¬ tinct. This part of the muscle forms a sort of semicircular loop, in which the levator palati muscle seems to be suspended. The pharynx has been laid open by a perpendicular incision through the constrictors in the mesial line, and the moveable portion of the palate has been dissected on one side. The circumflexus, or tensor palati, differs little from the natural condition; and the levator palati is much as it is usually met with, its lower end spreading out in all directions on the soft palate The palato-pharyngeus consists of two distinct bundles of fibres ; one, the smaller of the two, running between the tensor and levator palati; the other, a mass equal in size to a goose quill, seems to form the principal part of the free portion of the palate ; and posteriorly its fibres, previous to joining those of the other bundle, form the whole muscular portion of the posterior pillar of the fauces. This muscle arises by tendinous and fleshy fibres from the posterior margin of the osseous palate and the inner surface of the internal ptergoid plate, and takes its usual course and attachment posteriorly. A bundle of fibres, about the size of a crow quill, can be traced along the lower border of the inner margin of the soft flap. These fibres extend between the posterior margin of the hard palate and the uvula, and are probably analogous to the azygos uvule. The palato¬ glossus can scarcely be distinguished. A small arterial twig, doubtless a branch of the ascending pharyngeal artery, can be traced between the levator and tensor palati muscles. The throat and upper part of the pharynx generally is smaller than in the well formed state, but the deficiency in the mesial line of the palate seems more the result of a want of union, than of the usual materials of the velum. The act of deglutition in the natural state of the parts, while food is passing through the upper end of the pharynx, has been a subject ot considerable speculation among physiologists, especially with reference to the manner in which the communication betwixt that bag and the posterior nares is closed for the time being. It has been pointed out byDzondi and Muller that the palato-pharyngei muscles, when fixed in the soft tissues at their upper ends—as in the natural state of the velum —must, during contraction, tend towards the mesial line, and so by their approximation diminish the capacity oi the