On cleft palate : with cases in illustration of its successful treatment / by George Frederick Lane.

  • Lane, George F. (George Frederick), 1828?-1856.
Date:
[1851]
Catalogue details

Licence: Public Domain Mark

Credit: On cleft palate : with cases in illustration of its successful treatment / by George Frederick Lane. 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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    CLEFT PALATE, WITH OASES IN ILLUSTRATION OF ITS SUCCESSFUL TREATMENT. By GEORGE FREDERICK LANE, Esq. aESIDBNT-SURGEON AT THE ROYAL FREE HOSPITAL. Read on Thursdayy Feb, 13, 1851. The principal object of the present com- munication is to bring forward some cases of cleft palate in illustration of an improved method of rieatment furnished by modern surgery, the advantages of which, though well established in the minds of those who liave yielded it a thorough investigation, is still ques- tioned by many surgeons of eminence as operators who have hitherto been in the habit of practising the old opera- tion. This treatment differs widely in principle from the more usual method; and it becomes an important subject for consideration, as to how far the more recent operation is entitled to the im- TOvement which is claimed for it,—the isadvantages of the old proceeding, the advantages of the new one. Before, however, entering into the relative merits of the two operations, a few remarks upon the peculiar stracture and function of the parts concerned may not be deemed misplaced; though it will not be necessaiy to describe these in detail, but only to make reference to certain points bearing upon the opera- tions in question. The velum pendulum palati consists of muscular and glandular structure, enclosed in mucous membrane, and is a continuation of the palate posteriorly into a moveable flap, with an inclination downwards and backwards: it consti- tutes a valve at a point where two pas- sages meet, and is adequate to the closure of either of those for the tempo- rary advantage of the other. Its muscular portion forms a layer on its postero-superior surface, which is firmly attached hy tendinous and mus- cular fibres to the horizontal plates of the palate bones, and by muscular alone to the sides of the pharynx; by mingling with the superior constrictor, each side is also connected with the internal ptery- goid plate and hamular process of the sjjhenoid bone. It is covered by a thin mucous membrane, having numerous subjacent glands. The glandular portion is continuous with that covering the hard palate: it consists of firm but coarse glandular sfructui’o, intersected by fibrous septa, and contains an abundance of veiy tenacious mucus; anteriorly, and on each side, it forms about two thirds of the whole thickness of the velum, dimi- nishing, however, towai'ds the middle (producing a concavity con-esponding to the vault of the palate), and from before backwards towards its free border: it is covered by a thick and dense mu- cous membrane. The muscles consist of five pairs, of which one is united in the middle line, forming the azygos uvulso; they differ materially in size, and are of so complex an arrangement that their action is not veiy obvious. The leva'or palati has a direction downwards, inwards, and forwards, and is of equal size, and muscular through out. Each muscle spreads out at its inferior attachment, and is inserted into the middle of the velum palati, with tlie