Surgery of Deformities of the Face (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1912 Excerpt: ...toward the interval between the central and lateral incisor teeth. The location of the fissures in cases of harelip accords with that of the gaps in the anterior portion of the hard palate. This circumstance has been mentioned in considering harelip. When the frontal bud of the embryo does not unite with the maxillary buds laterally and develops forward abnormally, it develops into the protuberance attached to the nose, to which reference has been made in the section on harelip. The two central incisors are contained in this intermaxillary segment of the alveolus and hard palate. As the infant becomes older the cleft in the alveolus, if untreated may narrow perhaps and thrust the intermaxillary bone further forward. The cleft in the palate may be so incomplete as to be merely a bifid condition of the uvula. This needs no treatment, except as a cosmetic procedure. The edges of the fissure may be pared with a thin knife, such as is used for the corneal incision in cataract extraction, and the two halves of the uvula be brought together with thin silk or linen thread. A similar means may be employed, if the fissure extends forward toward the hard palate for a short distance. When this gap in the pendulous muscular palate reaches to, or almost to, the posterior edge of the bony palate, the operation must be a more extensive one. It should include detaching freely the soft palate from the posterior edge, and also from a considerabe portion of the oral aspect, of the bony palate. This detachment frees the soft palate, so that it falls downward toward the tongue. As a result injurious tension on the stitches is prevented and the sutures used to obtain apposition of the two lateral halves of the pendulous palate do not cut through the tissues. The impossibility of ...