On cleft palate / by Francis Mason.

Mason, Francis, 1837-1886.

Date:: 1877

Credit: On cleft palate / by Francis Mason. 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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operator proceeds to tie the ends of each succeeding thread; and supposing four sutures are employed, the practice I adopt is to Fm. 16. give the first thread, or that nearest the hard palate, to an assistant, who holds it at the centre of the forehead; the second is held over the patient’s ears, the third under the patient’s ears, and the fourth at the sides of the neck. Simple as this pro- ceeding may appear, it saves confusion to a marked extent, for when the time arrives for drawing together the sutures, there is no difficulty whatever in selecting the corresponding ends. As a rule, I secure the stitches from above downwards. The operation is completed by either dividing the muscles, accord- ing to Sir W. Fergusson’s plan, before the sutures are closed, if this has not already been done, or by taking the tension off the stitches by making a vertical incision, as Dieffenbach did, about a quarter of an inch in length on each side of the fissure. When necessary the anterior and posterior pillars of the fauces, with some fibres of the palato-glossus and palato-pharyngeus, may be divided. The accompanying woodcut (figs. 17, 18) show the incisions referred to. Respecting the operation a few practical points may not be out of place. There is often some difficulty in grasping the thread when passed through by the needle, but it may be easily secured if the needle be thrust freely and somewhat roughly through and slightly withdrawn at once ; but this must be done immediately and before the thread gets saturated with moisture. A slight loop in the ligature is thus formed, which

On cleft palate / by Francis Mason.

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