Observations on cleft palate : with cases illustrating the new operation of staphyloraphy / by William Fergusson.

  • Fergusson, William
Date:
[1849]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on cleft palate : with cases illustrating the new operation of staphyloraphy / by William Fergusson. Source: Wellcome Collection.

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    who, knowing my interest in such cases, kindly placed her under my care. I had the advantage of being assisted in the operation by both of these gentlemen. Case x. —. W., set. 26. The cleft extended through the soft parts only. The operation was performed on the 1st of March, 1846, and was followed by complete union, excepting in the two portions of the uvula, which were subsequently united by paring their edges, and retaining them in apposition by a single stitch. The non-union, at first, of the two parts of the uvula, I attribute to the soft parts drop¬ ping so much upon the root of the tongue, as to he disturbed by the movements of that organ. The voice and speech were soon remarkably improved in. this case. Case xi. T. S., set. 26, had a cleft extending through the soft, and one-half of the hard, palate. The operation was performed on the soft parts, 28th October, 1846, and was followed by perfect union. An obturator was used to fill the aperture in front, from which great improvement in voice and speech resulted. Case xii. J. M., set. 18, had a wide fissure in the soft palate. An operation had been performed some months previously, on the old plan, which had completely failed. My own process was resorted to, March 24th, 1848, with perfect success. The intellect of this patient was not of the brightest kind; and, although some improvement in the tone of the voice was perceptible, there was little amendment in his speech when he was last seen, some months after the operation. Case xiii. J. H., set. 16. The fissure was limited to the soft velum. The operation was performed on the 8th August, 1848; and the union was perfect. The voice was considerably improved ; but the patient left town too soon to permit a judgment to be formed regard¬ ing his speech. Case xiv. —. T., set. 29, had a very wide fissure in the soft palate, extending also through about three-quarters of an inch of the hard; the soft parts were very narrow and mobile. An operation was performed, 20th September, 1848, in which the soft structures were dissected from the bones, and brought together in the mesial line. The soft velum united satisfactorily, but the uvula remained split, seemingly for the reason stated in Case x: a small slough formed in the tissues dis¬ sected from the bones, in the site of one of the stitches, and an aperture remained in this situation. I am still in doubt whether it will be prefer¬ able to apply an obturator here, or to repeat the operation, in order to close the circular opening now remaining. My friend, Mr. Henry Lee, did me the honour, two years previously, to submit this case for my opinion, when I advised that an operation should not be performed. I was led to this decision by considering that there was little probability of the parts being united in a satisfactory manner. Moreover, the patient spoke so remarkably well (under the circumstances), that there seemed no great hope of improvement, even were the operation successful ; and, in addition, I was of opinion that no improvement in hearing would result. This patient, like many others with this malformation, was very deaf, and more desirous of relief in this respect than as regarded the palate or speech. She assented at the time to the opinion
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