Operation for closure of cleft of the hard and soft palate / by A. Vanderveer.

  • Vander Veer, A. (Albert), 1841-1929.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Operation for closure of cleft of the hard and soft palate / by A. Vanderveer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    postpone the operation on the cleft for another year, when, in the case of the boy, all the good that the soft parts can do in approximating the fissure will have been accomplished ; and, in addition, in the case of the girl, what we consider the proper age for doing the cleft operation will have been reached. In this opinion, my colleague. Professor Ward, coincides. The operation on the girl will be for simple harelip ; in the boy’s case, we have more to give us anxiety and to exercise our judgment. In the majority of cases where we have this inter- maxillary bone presenting as an island, it is better to preserve it and attach the lip to it on each side, after making efforts to press or bring it Jaack on a level with the alveolar ridge or the upper jaw. When the harelip exists on both sides, my experi- <ence teaches me in operating that it is best to operate on only one side at a time ; but in the case of this boy, the island is so very prominent, and ossification so far advanced that we shall have to remove a portion of the projecting bony substance, having in it the two middle incisors of the temporary, and the sacs of the corresponding teeth of the pir.nanent set, and will then be able to bring the soft parts of the lip directly together in one operation. As we shall do here, always save what you can of the skin and periosteum covering the island. As you observe, after loosening up these tissues, we remove the bony portion with the curved bone forceps, controlling the deep hemorrhage (which is sometimes very severe) by applications of ice, and then bringing the fissures together in the ordinary manner by use of harelip pins and figure-of-eight silk suture. This, you see, now after the operation, has had an effect to nar- row the appearance of the face very much, and has already in a wonderful manner improved his looks.* Perhaps it is well to repeat to you in connection with these cases what we have * This patient made an excellent recovery and result.