The bones that form the hard palate do not unite in the
median line and a longitudinal opening is left in the roof of the mouth.
This is called Cleft Palate.
Symptoms. Of course, upon examination this split is seen. It may involve
not only the hard palate, but also the soft palate and uvula. It is then
generally accompanied by single or double hare-lip. When the severe forms
occur they cause great trouble. Fluid
pass freely into the nose, and
unless the child is carefully fed by hand it will soon die, as it is
unable to suck. In the less severe forms the child soon learns to swallow
properly, but when he learns to speak he cannot articulate properly and
his voice is nasal.
Treatment. For this reason an early operation is advisable, not so early
as for hare-lip, but before the child has learned to speak, say between
the age of three and four when faulty speech (articulation) may be
overcome by successful closure of the palate. When the operation is done
late, the patient will not be able to overcome the bad habits of
articulation acquired in his childhood.
Operation. The anaesthetic is necessary. The end of one-half of the cleft
palate is seized with an instrument and the edge freely pared with a thin
bladed sharp knife; same with the other half. Then the stitches are put in
of silk worm, gut or wire. The patient is fed on liquid food for three or
four days, and afterwards on soft food until the stitches are removed.
They are removed about the sixth or eighth day, and the wound should be