Observations on cleft palate : with cases illustrating the new operation of staphyloraphy / by William Fergusson.

  • Fergusson, William.
Date:
[1849]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on cleft palate : with cases illustrating the new operation of staphyloraphy / by William Fergusson. Source: Wellcome Collection.

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    band untouched; but came so close upon its roots at each side, that it could not afterwards be recognized. Case v. S. S., set. 22. The fissure extended through the soft palate, and nearly one-half of the hard. On the 8th of May, 1845, the soft parts were brought together, and the union was, in due time, complete. Three weeks afterwards, the soft structures were dissected from the hard palate, and brought together in the middle. On the third day, when the stitches were removed, the union seemed perfect; but in two days more the junction opened; and, ere long, as the soft parts became united to the bones, the orifice was as wide as ever. The union of the soft velum remained perfect. Case vi. W. F. G., set. 24. The extent of the fissure was about the same as in the last case; and the soft parts were thin, narrow, and remarkably mobile. The operation was performed on the 8tli of Octo¬ ber, 1845. The spasm of the muscles, when the parts were touched, was so great, that the preliminary incisions were not so fully carried out as I desired; nevertheless, union took place throughout the whole extent of the soft palate. An oval hole remained in front, where, owing to the flatness of the osseous roof, it was not deemed advisable to attempt an operation. An obturator was afterwards applied by Mr. Saunders, with the result of obviously improving the articulation. Case vii. J. B., set. 11, had a fissure in the soft parts only. The patient and his friends were particularly anxious that an operation should be performed. Although fearful that the boy might not keep sufficiently quiet, I trusted, on this occasion, to his assurance that he would. He kept his word; and the proceedings were most satisfac¬ torily accomplished. On the second day, union seemed perfect, and I removed the stitches; but during the subsequent night, the whole separated, and the gap was as wide as ever. I attribute the failure in this case chiefly to the removal of the stitches at too early a period. Probably, during sleep, or in taking food, the parts had been over¬ stretched, and the delicate adhesions had given way. Case viii. G. B., set. 16. The fissure extended through the soft, and the greater portion of the hard palate. An operation, limited to the soft palate, was performed on the 16th October, 1845, with com¬ plete success. An obturator was afterwards adapted to the opening, and the improvement in voice and speech was very satisfactory. This patient, like most others similarly affected, had a hare-lip when bom, which had been operated on in early life ; the malformation was, how¬ ever, still very marked. Another operation was performed some months after that on the palate, with the effect of greatly improving both the speech and appearance. Mr. Saunders, who constructed the obturator, tells me that he has recently seen this gentleman in conse¬ quence of some modification of the apparatus being requisite, and that the result of our conjoint proceedings is all that could be desired. Case ix. C. T., set. 16, had a fissure limited to the soft palate. A completely successful operation was performed on the 8th of December, 1^45. This patient was brought by Mr. T. A. Richards, of Green, terrace, Camberwell, to my friend Mr. S. Lane, of Grosvenor-place-