. St. Thomas's Hospital reports. ? to this point I may hepermitted to remind the reader tliat a cleft in the palateis not a mere rent or slit in the parts, hnt an actnal defi-ciency or want of tissue. Hence, however well satisfied thesurgeon may be with his work, the soft jialate still remainsas a tight curtain stretched across l)etween the mouth andposterior nares. The result is that, in speaking, the air insteadof passing into the month gains ready access to the nostrils,and thus the peculiar nasal tAvang is occasioned. In order toobviate this I release the soft palate in the following manne
. St. Thomas's Hospital reports. ? to this point I may hepermitted to remind the reader tliat a cleft in the palateis not a mere rent or slit in the parts, hnt an actnal defi-ciency or want of tissue. Hence, however well satisfied thesurgeon may be with his work, the soft jialate still remainsas a tight curtain stretched across l)etween the mouth andposterior nares. The result is that, in speaking, the air insteadof passing into the month gains ready access to the nostrils,and thus the peculiar nasal tAvang is occasioned. In order toobviate this I release the soft palate in the following operation may be performed at any time after the completeclosure of the soft palate, say a month or more:—A smallcurved spatula is first placed behind the soft palate; it keepsthe part steady and also serves as a point d^appui. A sharp-pointed knife is then introduced from before backwards atA (fig. 29), in about the position of the inner edge of the Fig. hamular process in the normal palate (d), and the soft palate iscut completely through from above downwards from a to same thing is repeated on the other side, and the operationis then concluded. In the first few cases on which I operated 1 Lancet, vol. ii, 1869, p. 198. 90 On Cleft Palate. I hemmed the mucous membrane, hack and front, as indicatedin tlie diagram e, but I have long since abandoned this practiceas nnnoccssary, for when the parts unite they do so at theV-sliapcd angle where these are in immediate contact (dottedline f). The operation is very simple and may be repeated asoften as necessary, is perfectly free from danger, and almostpainless. The rationale of the proceeding is easily palate becomes converted into a huge uvula, so to is shortened and puckered up, the point b being drawn up toc, so that if it does not actually touch the back of the pharynxit approaches it so nearly as to divert the current of air to aconsiderable extent from the
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