Case of extensive congenital division of both the hard and soft palates : successfully treated by mechanical means / by James Snell.

  • Snell, James.
Date:
[between 1820 and 1829?]
Catalogue details

Licence: Public Domain Mark

Credit: Case of extensive congenital division of both the hard and soft palates : successfully treated by mechanical means / by James Snell. 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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    —q c g i> * 2u\>.cq t Case of extensive Congenital Division of loth the Hard and Soft Palates, successfully treated by Mechanical Means. By James Snell, Dentist, Member of the Royal College of Surgeons in London. The extreme importance of any successful contrivance, in so distressing a defect as that of a fissured palate, will render unnecessary any apology for introducing the following case to the Profession. An interesting young lady, now about sixteen years of age, has laboured under this distressful malformation from her birth. When an infant, it deprived her of the support of the breast,— the milk, when any could be drawn, being invariably ejected through the nose ; and her articulation, from a later period to the time of my seeing her, was so defective as not to be understood but by those who were constantly about her. On her application to me about three months ago, the appear- ances were as follow : —The fissure, as may be seen by reference to the plate, commenced imme- diately behind the two anterior incisores, extending backward through the palatal portion of the maxillary bone, and through the os palati, velum pendulum palati, dividing the uvula, and giving rise to an unlimited communication between the nose and mouth. When the case first came under my care, I was desirous of making the attempt to unite the edges of the soft palate, according to the suggestion of M. Roux ;* but this mode of proceeding being altogether objected to by the parents, I was induced to try how far success might be obtained by mechanical means. With this view I obtained a correct model of the deficiency, from which a gold plate was first fitted to the roof of the mouth, as far back as could be worn by the patient, to the posterior part of which two pieces or flaps of Indian Rubber were attached, thus filling up the deficiency of the soft palate. A small moveable piece of the same material was also attached, by means of a gold hinge, to the centre of the lower piece, to imitate as near as possible the natu- ral uvula. A piece of ivory was next fitted to the upper or back part of the gold plate, and carried upwards until it came in contact with the remaining portion of the septum narium: this was of course, firmly attached. The whole was held up in its situation by means of two gold springs soldered to the plate, which attached themselves round one of the molares on either side. It may readily be conceived that the introduction of such an apparatus must, in the first instance, cause I HHI * Medical Intelligencer, Vol. 1. p. 98.