Cleft palate and harelip.

Date:
1908
Catalogue details

Licence: Public Domain Mark

Credit: Cleft palate and harelip. Source: Wellcome Collection.

Provider: This material has been provided by the University of Toronto, Harry A Abbott Dentistry Library, through the Medical Heritage Library. The original may be consulted at the Harry A Abbott Dentistry Library, University of Toronto.

    12/24 page 178
    1Y8 first packing may now be removed, when one, as a rule, finds that all hemorrhage has ceased. Returning to this flap again, the edges forming the sides of the cleft are carefully pared A\ath a small tenotomy knife, cutting as thin a slice as possible, at the same time making certain to include the whole thickness of the flap margin. The denudation should begin posteriorly within the soft palate, but need not include the uvula. By the time the edges are pared on the one side, the packing may be removed from the lateral incision on the other, and the edges of that flap pared in a similar way. (Fig. 5.) While the newly-pared edges are still oozing, and before there is time for them to become glazed over with mucus, the sutures are introduced. Horsehair is used, and the sutures are passed about Fig. 6. Showing sutures in anterior portion of cleft and outline for posterior flap. one-eighth of an inch from the margin, and about a quarter of an inch apart, beginning at the anterior angle. When the required number of sutures have been passed they are tied, care being taken that the raw edges are carefully approximated, and that the stitches are not tied with too great tension. A flap is now outlined upon the soft palate (see Fig. 6, a). If need be, one may encroach upon the cheek to make sure that there will be no tension upon this flap. This is dissected up, superficial to the tensor palati, making as it were a hinge at the free margin of the soft palate. An incision is then made along the free margin of the cleft on the opposite side (Fig. 6, 6) and a flap is here undermined. Into this flap (Fig. 6, c), at its base, a suture is passed, carried over and through from the raw surface to
    digitised image 1
    digitised image 2
    digitised image 3