- A.
- Accessory teeth in harelip, 54
- Acquired apertures in palate, treatment of, 144
- Adenoids in cleft palate, 71
- question of removal of, 70, 104
- Adults, harelip in, 69
- After-treatment of harelip operations—
- immediate, 85
- mechanical and manual aids, 148
- secondary operations for broad columna nasi, 148
- V-notch, 147
- After-treatment of palate operations—
- educational, 150
- for tension of velum, 149
- immediate, 127
- Age for harelip operations, 74
- palate operations, 101
- Albrecht, chief works of, 49
- on accessory teeth in os incisivum, 54
- on intermaxillary sutures, 27
- on morphological position of alveolar harelip, 45, 48
- Alveolar harelip, 3
- dentition of, 51, 54
- morphological position of, 48
- Anæsthesia in cleft palate operations, 105
- in harelip operations, 77
- per rectum, 157
- Animals, occurrence of deformities of, 10
- Articulation, action of palate in, 35
- defective after successful operation, 150
- education required to improve, 150
- in cleft palate, 69
- Artificial vela, arguments for, 143
- definition of, 139
- objections to, 144
- varieties of, 142
- Assistant, duties of, in palate operations, 107
- Atresia of nose, congenital, 14
- Auricular appendages in macrostoma, 20
- Author’s gag for operations on mouth, 109
- incisions for double harelip operation, 98
- single harelip operation, 81
- B.
- Bardeleben’s treatment of os incisivum, 94
- Biondi on intermaxilla, 47
- Blandin’s treatment of os incisivum, 94
- Bony suture of palate, or osteoplasty, 133
- Breadth of cleft palate diminished after closure of lip, 73
- palate decreased after closure of cleft, 151
- Breath, fœtid, in cleft palate, 71
- Buccal cleft, or macrostoma, 19
- Butcher’s treatment of os incisivum, 95
- C.
- Callender on intermaxilla, 46
- Carless on intermaxillary sutures, 26
- on intra-uterine cicatrix of lip, 5
- on maternal shock, 25
- Causes of congenital deformities, 23
- Caustics in acquired deformities, 156
- use of, after palatal operations, 132
- Cheiloplastic operations for harelip, 91, 99
- Classification of deformities of mouth, 1
- Cleft palate, absence of uvula in, 9
- action of muscles in, 64
- arrangement of muscles in, 63
- articulation in, 69
- associated deformities, 11, 65
- closed by facial flaps, 137
- condition of pharynx in, 71
- cranial deformities associated with, 65
- development of, 59
- effect of varying slope of segments, 65
- feeding of patients with, 67
- fœtid breath in, 71
- frequency of, 9
- functional results of, 67
- influenced by closure of harelip, 73
- moral effect of, 69
- occurrence in animals, 10
- operative treatment of (see Operative treatment of cleft palate)
- pharyngeal complications, 71
- slope of segments in, 9, 65
- taste in, 71
- uncommon varieties of, 8
- varieties of, 5
- vomer in, 6
- width of, 9
- Coles, nipple-shield for feeding infants with cleft palate, 68
- on cranial deformities in cleft palate, 65
- on size of normal palate, 32
- Collis’s operation for unilateral harelip, 90
- Collodion dressing for harelip, 84
- Columna nasi, condition of, after bilateral operation, 146
- secondary treatment of, 148
- Condition of palate, immediate, after operation, 126
- remote, after operation, 151
- Cranial deformities in cleft palate, 65
- D.
- Davies-Colley, method of closing cleft palate, 134
- Deformities associated with harelip and cleft palate, 11
- of cranium in cleft palate, 65
- of palate associated with mental dulness, 33
- Deglutition, normal action of velum in, 34
- Dentition in alveolar harelip, 51, 54
- in facial clefts, 58
- Desault on treatment of os incisivum, 93
- Development of anterior nares, 41
- of bones of skull, 42
- of eyes, 38
- of face, 37, 41
- of intermaxilla, 43, 44
- of mandible, 37
- of mouth, 36
- of nasal duct, 41
- of nose, 39
- of palate, 40, 43
- of teeth, 43
- of tongue, 41
- Dieffenbach’s operation for unilateral harelip, 91
- Division of levator palati by Fergusson’s method, 125
- Pollock’s method, 126
- Dog-nose, 15
- Double harelip, median tubercle in, 61
- operative treatment for (see Operative treatment for double harelip)
- os incisivum in, 3, 62
- Dressing for harelip operations, 84
- E.
- Edges, how to pare, in cleft palate, 120
- Education of patients after palatal operations, 150
- Ehrmann on change of shape of palate after uranoplasty, 151
- on normal shape and size of palate, 32
- statistics of early operations for cleft palate, 101
- Endognathion, 27, 45
- Exognathion, 27, 45
- External nasal process, 39
- its relation to the lip, 56, 57
- Extirpation of os incisivum, 92
- v. reposition, 96
- F.
- Facial cleft, 16
- associated with harelip, 18
- morphological position of, 57
- varieties of, 17
- Feeding of infants after harelip operations, 76, 85
- with cleft palate before operation, 67
- after operation, 128
- Fergusson (Sir W.), loop-method of passing sutures, 121
- method of dividing muscles in staphyloraphy, 125
- on muscles in cleft palate, 63
- on os incisivum, 62
- osteoplasty, 133
- Fissure of cheek (see Macrostoma), 19
- lower lip (see Mandibular cleft), 21
- palate (see Cleft palate), 5
- upper lip, facial cleft, 16
- harelip, 2, &c.
- median harelip, 12
- Fœtid breath in cleft palate, 71
- Food, regurgitation of, in cleft palate, 67
- Forceps for palate operations, 111
- Franco on removal of os incisivum, 92
- G.
- Gag, author’s, in operations on the mouth, 109
- Mason’s, 109
- T. Smith’s, 108
- Gensoul, forcible repression of os incisivum, 93
- Gilis on intermaxilla in fœtus, 46
- Giraldés’ or mortise operation for harelip, 88
- Globular processes, 39
- absence of, in median harelip, 58
- Goethe on intermaxilla, 45
- on morphological position of alveolar harelip, 45, 48
- Graefe, operation for unilateral harelip, 86
- H.
- Hæmorrhage in palate operations, 117, 126
- secondary, 132
- Hainsby’s truss, 84
- Hard palate, abnormal shape of, 33
- function of, 34
- history of operations upon, 115
- measurements of, 32
- mucous membrane of, 30
- operative treatment of (see Operative treatment of cleft palate)
- osteology of, 26
- shape of, 32
- after uranoplasty, 151
- syphilitic disease of, 154
- vascular supply to, 30
- Harelip, action of labial muscles on, 60
- ætiology of, 23
- alveolar (q. v.), 3
- anatomy of, 60
- associated deformities, 11
- causes of nasal deformity, 61
- characters of, 2
- condition of parents’ mouths in, 23
- connections with maxillæ, 61
- frequency of, 9
- hereditary character of, 23
- intra-uterine closure of, 5
- maternal impression or shock in, 24
- median (see Median harelip), 12
- nose, shape of, in, 3
- occurrence of, in animals, 10
- operation for double, author’s, 98
- Bardeleben’s, 94
- Blandin’s, 94
- Butcher’s, 95
- Desault’s, 93
- Franco’s, 92
- Gensoul’s, 93
- Langenbeck’s, 95
- Sédillot’s, 99
- T. Smith’s, 100
- operation for single, author’s, 81
- Collis’s, 90
- Dieffenbach’s, 91
- Giraldés’, 88
- Graefe’s, 86
- König’s, 89
- Malgaigne’s, 87
- Mirault’s, 89
- Nélaton’s, 86
- Stokes’s, 89
- operative treatment for (see Operative, &c.)
- double, 92
- single, 77
- percentage of, in different sexes, 4
- Hare’s lip, characters of, 2
- Heredity in harelip, 23
- Hexaprodontous jaws, 27, 53
- I.
- Incisions in uranoplasty, 117
- hæmorrhage from, 117, 126
- lateral, in staphyloraphy, 126
- secondary hæmorrhage from, 132
- Instruments for palate operations, 108
- Intermaxilla, absence of, in median harelip, 12
- Albrecht on, 45
- Biondi on development of, 47
- Callender on, 46
- development of, 39, 43, 44, 56
- Gilis on development of, 46
- Goethe on, 45
- Intermaxillary sutures, number of, 27, 46
- relations of, to alveolar harelip, 47
- to facial cleft, 57
- to median harelip, 58
- Intra-uterine closure of harelip, 5
- J.
- Jaw, treatment of aperture after removal of upper, 145
- K.
- Kölliker on dentition in alveolar harelip, 52
- König, operation for unilateral harelip, 89
- L.
- Langenbeck on condition of palate after operation, 151
- operation of uranoplasty, 115
- treatment of os incisivum, 95
- Levator palati, description of, 28
- division of, by Fergusson’s method, 125
- by Pollock’s method, 126
- function of, 29
- Lip, compressors of, in harelip operations, 80
- development of lower, 37, 58
- of upper, 39, 56
- underhung condition of lower, 147
- use of collodion in depressing lower, 85
- M.
- Macrostoma, 19
- auricular appendages in, 20
- morphological cause of, 58
- results of, 21
- Malgaigne, operation for unilateral harelip, 87
- Mandibular cleft, 21
- morphological cause of, 58
- Mason’s gag, 109
- method for relieving tension of united velum, 149
- modification in osteoplasty, 133
- teat for infants with cleft palate, 67
- Maternal impression or shock, 24
- Mechanical and manual after-treatment of harelip operations, 148
- Median harelip, 12
- cerebral malformations in, 14
- cranial defects in, 14
- morphological cause of, 58
- with intermaxilla absent, 12
- with intermaxillary cleft, 14
- Mental development in relation to shape of palate, 33
- Mesognathion, 45
- in alveolar harelip, 49
- Mirault, operation for unilateral harelip, 89
- Mouth, development of, 36
- Muscles of soft palate, 28
- division of, in staphyloraphy, 125, 126
- N.
- Nasal twang in cleft palate, 69
- causes of persistence of, after operation, 150
- Needles for palate operations, 112
- Nélaton’s operation for unilateral harelip, 86
- use of, for recurrent V-notches, 147
- Nesbitt on palatal sutures, 45
- Nipple-shield for infants with cleft palate, 68
- Nose, development of, 39
- shape of, in harelip, 3
- shape of, in harelip, cause of, 61
- shape of, in median harelip, 13, 14
- Nutrition, difficulty of, in cleft palate, 67
- O.
- Obturators, arguments in favour of, 143
- characters of recent, 141
- definition of, 139
- for acquired apertures, 144
- objections to, 144
- review of history of, 140
- use of, 144
- Operative treatment by facial flaps, 137
- of acquired apertures of palate, unsatisfactory character of, 156
- Operative treatment of cleft palate—
- after-complications, 129
- after-treatment, 127
- anæsthesia, 105
- anterior part of cleft, treatment of, 135
- assistant’s duties, 107
- condition of palate after, 151
- education of patient after, 150
- facial flaps employed for, 137
- hæmorrhage in, immediate, 117, 126
- secondary, 132
- history of, 115
- instruments for, 108
- osteoplasty, 133
- period for, 101
- position of patient in, 104
- preparation of patient, 103
- shape of palate after, 151
- staphyloraphy, 126
- superiority of, to mechanical appliances, 144
- sutures, materials employed for, 113
- methods of passing, 121, 123
- period for removal of, 129
- typical result, 149
- uranoplasty, 115
- Operative treatment of harelip—
- after-treatment, 85
- anæsthesia, 77
- detachment of lip from maxilla, 78
- dressing employed, 84
- effect of, on width of palatal cleft, 73
- feeding of infant after, 76, 85
- formation of prolabium, 79
- Hainsby’s truss, 84
- lip compressors in, 80
- period for, 72
- pins, use of, in, 81
- position of patient, 77
- preparation for, 76
- prevention of V-notch, 79
- stages of, 77
- statistics of, 74
- suturing lip, method of, 83
- typical result, 79, 146
- V-notch after, 147
- Operative treatment of double harelip (see Harelip, operations for double)—
- of labial tissues, 98
- of os incisivum (q. v.), 92
- usual result of, 147
- Operative treatment of single harelip (see Harelip, operations for single)
- Os incisivum, dentition of, 54, 62
- description of, 61
- position of, in double harelip, 3
- Os incisivum, treatment of—
- extirpation (Franco), 92
- extirpation v. reposition, 95
- fixation of, after reposition, 95
- forcible repression (Gensoul), 93
- gradual repression (Desault), 93
- reposition after division of septum (Blandin, Bardeleben, Butcher), 94
- Osteoplasty, Fergusson’s operation, 133
- Mason’s modification, 133
- reasons for discontinuance, 133
- P.
- Palate, acquired apertures in, 144, 154
- cleft (see Cleft palate)
- development of, 40, 43
- hard (see Hard palate)
- processes, 40
- soft (see Soft palate)
- Passavant on narrowing of cleft palate, 73
- Period for operation on cleft palate, 101
- on harelip, 72
- Philtrum, 62
- treatment of, 98
- Phonation in cleft palate, 35
- Pins, use of, in harelip, 81
- Pollock, method of dividing levator, 126
- on cleft palate, 64
- Position of patient in operation for cleft palate, 104
- for harelip, 77
- Preparation of patient in operations for cleft palate, 103
- for harelip, 76
- Prevention of V-notch, 79
- Prolabium, formation of, 79
- R.
- Raspatories for palate operations, 110
- Reposition of os incisivum (see Os incisivum), 93
- Rose (E.), position in palate operations, 104
- Rose (W.), gag, 109
- operation for double harelip, 98
- single harelip, 81
- S.
- Secondary operation for closing fistulas in palate, 131
- prominence of lower lip, 97, 148
- reducing size of columna, 148
- tension of united velum, 149
- V-notches, 147
- possibility of, after sloughing, 138
- Sédillot, operation for double harelip, 99
- Shape of hard palate, after uranoplasty, 151
- normal, 32
- Smith (T.), direct method of suturing palate, 123
- gag, 108
- modification of uranoplasty, 134
- needle for palate operations, 124
- operation for double harelip, 100
- Soft palate, functions of, 34
- muscles of, 28
- methods of division of, 125, 126
- vascular supply of, 31
- Stages in operation for cleft palate, 116
- harelip, 77
- Staphylo-pharyngoraphy, 137
- Staphyloplasty, 137
- Staphyloraphy, 126
- Statistics of early operations for cleft palate, unfavorable, 101
- operations for harelip, 74
- Stokes’s operation for single harelip, 89
- Sutton on median harelip, 13
- Sutures, direct method of passing, 123
- loop-method of passing, 121
- materials employed for, in lip operations, 83
- in palatal operations, 113
- method employed for adjusting, in double harelip, 99
- single harelip, 83
- period of removal of, after lip operations, 84
- after palate operations, 129
- Syphilitic affections of hard palate, 156
- velum, 155
- treatment of, 156
- T.
- Taste, improvement of, after closure of cleft palate, 150
- in cleft palate, 71
- Tertiary syphilitic affections of palate, 156
- Tonsils, enlargement of, in cleft palate, 70
- treatment of, 103
- Typical result after operation for cleft palate, 149
- harelip, 146
- U.
- Underhung lip after removal of os incisivum, 96, 147, 148
- Uranoplasty (see Operative treatment for cleft palate)
- description of, 116
- effect of, on shape of palate, 151
- history of, 115
- Uvula, absence of, 9
- fissure of, 8
- method of suturing, 123
- muscles of, 29
- V.
- Velum palati (see Soft palate)
- V-notches in lip margin after operation, 79
- treatment of, 147
- Voice, causes of non-improvement in, after operation, 150
- characters of, in cleft palate, 69
- education of, necessary, 150
- Vomer, condition of, in double harelip, 6, 63
- development of, 41, 43
- position of, in cleft palate, 6
- treatment of, in double harelip, 93
- use of mucous membrane over, 134
- W.
- Warner on association of mental dulness, &c. with deformed palates, 33
- Wolf-jaw (Ger. Wolfsrachen), 3, 6
- Wolff’s artificial velum, 143
- Wölfler on mandibular clefts, 58
About This Book
The work presents a systematic survey of congenital fissures affecting the lip, alveolus, and palate, classifying median, unilateral and bilateral harelip, facial and mandibular clefts, and cleft palate; it examines frequency, anatomical variations, and embryological development, considers proposed causes, and describes feeding adaptations. The major practical portion gives detailed operative techniques, choice of incisions, instruments, sutures, and postoperative care, illustrated with diagrams and clinical examples; historical methods and comparative animal cases are noted to contextualize surgical advances and decision-making.