On the treatment of cleft palate / by Lawson Tait.

  • Tait, Lawson, 1845-1899.
Date:
[1870]
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of cleft palate / by Lawson Tait. Source: Wellcome Collection.

    3/14
    ON THE TREATMENT OF CLEFT PALATE. It is not my intention here to speak of the history of the various operations for the varieties of this deformity, as these have been already sufficiently made known; nor do I wish to mention anything except my own experience of the treatment of the condition, with the single exception that I should like to draw attention to two circum¬ stances in connection with its etiology. These are, first, that the deformity seems to be endemic in some localities, cases occurring with extraordinary frequency; while in others it is absolutely unknown.1 This seems to be the case in different districts in York¬ shire. Secondly the deformity is, invariably in my experience, hereditary. I have never yet seen a patient with cleft palate in whose family, if the family history is known for any distance back, it has not occurred before. Yery frequently in the same family of children two or three will have different varieties of cleft. The deformity is often atavic, and I have known it to miss as many as three generations. I mention these facts because I believe they are not sufficiently known, and are not mentioned by the authors I have read. The most frequent variety of intermaxillary cleft is the simple unilateral harelip. The mesial cleft lip is so rare, that only two specimens are known to exist. The bilateral cleft is, as far as sur¬ gical proceeding is concerned, practically the same as the unilateral, save when the premaxillary bones project from the end of the vomer. In this case the operation must be performed at two sittings, the first consisting of the division of the bony attachment of the dis¬ placed bones, the paring of their edges and of the corresponding edges of the maxilla, and the insertion of the premaxillaries into the cleft. This has in my hands always been successful. For the after part of the operation, for the union of the lip, a variety of operative measures have been recommended, and most of them I have tried without having found that any of them are, in their results, in the least superior to the old-fashioned incision straight through the lip with a slight deviation inwards at the bottom, to form a prolabium, with the removal of plenty of tissue. I have seen very disappointing results when a thin shred of tissue has been removed. 1 I understand that nearly all the lion cubs horn in the Regent’s Park Gardens have cleft palate, and that this is not known to occur in other collections.