Fissure of the soft and hard palate / [Jonathan Mason Warren].

  • Jonathan Mason Warren
Date:
1848?]
Catalogue details

Licence: Public Domain Mark

Credit: Fissure of the soft and hard palate / [Jonathan Mason Warren]. Source: Wellcome Collection.

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    understood, being made continuous with the fissured halves of the soft palate. Second, in the above cases, and, in fact, in all where the lateral halves of the soft palate are too small to be easily brought in contact, as gener- ally happens where the bones are involved, to cut away the posterior pil- lar of the palate with strong curved scissors, and continue the dissection behind the soft palate, until the latter yields, and allows itself to be drawn across the chasm, which, by the above proceeding, will be found practi- cable, even in those fissures which at first do not seem to offer the slight- est hopes for a successful operation. | The advantages to be derived from this second proposition, namely, the division of the posterior pillar of the palate, are so important, that the steps for effecting this object will now be given. ‘The uvula being seized with a pair of hooked forceps, and the velum made tense, with a long pair of powerful scissors, curved on the flat side, the posterior pillar is excised, when the soft parts in front will be found to yield. If neces- sary, a second and third cut may be made, when the portion which at first offered violent resistance, will be found to hang flaccid in the throat, and all the subsequent manceuvres of the operation can be conducted with ease. The importance of the preceding step will be made sufficiently evident by the successful result in those cases in which it has been performed. We have alveady referred to the last reported cases of Professor Roux. From the same article it appears, that his success in cases where the fis- sure was complicated with a division of the bony palate, was one out of three, but in these no attempt seems to have been made to close the aper- ture in the bones. In regard to the cases performed by the writer, ac- cording to the present propositions, of the fourteen already published, thirteen proved successful, and in the ten cases now to be given, all had a favourable termination. ‘This is the more striking, when it is considered that twenty-three out of twenty-four of them were more or less compli- eated with fissure in the bones, a fact which also shows the rarity of a perfectly simple fissure of the soft parts. Since the publication of the above method for relieving these deformities, it has been repeated elsewhere, both in this country and.abroad. Among others who have given much attention to this subject, is Mr. Fergusson, the distinguished Professor of Surgery at King’s College, London. This gentleman has published a paper in the Medico-Chirurgical Transactions, for 1845, in which he calls the attention of the profession to the impor- tant influence exerted by the muscles of the palate,in the operation for