Operative surgery, for students and practitioners . aration betweenthe nostrils. This condition may be so pronounced that the noseappears to consist of tw^o halves completely separated from eachother and each containing one nostriL Instead of this extreme de-gree of deformity the nose may be simply flattened, the bridge de-pressed, the nostrils far apart and looking directly forward: dognose. The fissure in the upper lip instend of simply notching the 12 178 HEAD AND FACE. lip may extend completely through the Avhole lip and into the inter-maxillary bone. This variety of deformity may also be
Operative surgery, for students and practitioners . aration betweenthe nostrils. This condition may be so pronounced that the noseappears to consist of tw^o halves completely separated from eachother and each containing one nostriL Instead of this extreme de-gree of deformity the nose may be simply flattened, the bridge de-pressed, the nostrils far apart and looking directly forward: dognose. The fissure in the upper lip instend of simply notching the 12 178 HEAD AND FACE. lip may extend completely through the Avhole lip and into the inter-maxillary bone. This variety of deformity may also be representedby a fistnla of the tip or dorsum of the nose. Lateral Nasal Clefts.—These occur with or without harelipand cleft palate; the notch or fissure involves the wing of the they extend upward for a considerable distance through the sideof the nosC;, they terminate above, not in the inner canthus, but tothe inner side of the inner corner of the eye; they represent theembryonal notch between the middle and lateral nasal jDrocesses of. Fig. 92.—Transverse Facial Cleft. the frontal plate. Fissures of the side of the nose, that resemblethese, but terminate above in the inner canthus of the eye, are vari-eties of oblique facial clefts. Oblique Facial Clefts.—Failure of normal union between thelateral process of the frontal plate and the superior maxillary processof the first visceral arch. They correspond to the embryonal orbito-nasal line of coalescence. These deformities may be very extensiveor slight: one-sided or double. They commence below at the edgeof the upper lip, and, after splitting this at the usual harelip site,extend upward through the cheek, alongside of the wing of the nose,not into the nostril like harelip, and terminate above, at the lowermargin of the eye (lower lid) or inner canthus. They may extendbeyond the orbit, from its outer corner, upward and outward intothe fronto-temporal region of the skull. They vary from a narrow OPERATIONS FOR HAKE
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