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The use of fascia in jaw-surgery
ABSTRACTS
OF
CURRENT
563
LlTERATURE
For the complete cleft of the palate, either single or bilateral, the author prefers the Veau type of operation if the cleft involves the anterior part of the palate and the alveolar process. In cases of single palatal cleft and associated single harelip, the Veau type of closure of the anterior half of the palate and of the alveolar process is combined in a single stage with a Mirault type of repair of the harelip. In eases of bilateral complete cleft palate and bilateral harelip, the bilateral Veau operation and the bilateral repair of the harelip sometimes can be done as a single operation, or the anterior part of the palate and the lip can be repaired on one side only at one time, and the same operation done on the other side after an interval of from ten days to two weeks. Often, the decision whether to use the ‘single-stage or the two-stage method is not made until the defect of one side has been repaired. If the operation has proceeded smoothly thus far and if the child is taking the anesthetic well and is in good condition, one can proceed with the repair of the defect on the other side; otherwise, it is better to defer the remainder of the repair until later. To the Genesis
of Harelip.
G. Tijndury.
Pratt.
oto-rhino-laryng.
10: 146, 1948.
The author defines the meaning of “harelip” and rejects the classical teaching of the origin of the harelip. The embryonic face is not based on the existence of processes and clefts which have to be joined, but only on few little apparent superficial grooves. If a real cleft is found it is usually a pathologic condition. In the transformation of the nasal grooves into the nasal tubes, the sides of the nasal groove come together and slowly cover the groove from behind toward the front. On this side of the suture originates the Hochstetter epithelial wall. Under normal conditions the epithelial wall in its anterior part is pierced again by mesenchyme and disappear.s entirely. A human embryo of 13 mm. S.S.L. is being described with a left-sided The comparison of both sides indicates that the harelip, the right side being normal. mentioned fissure is the primary cleft originating in consequence of a lack of build-up The comparison with other observations of older of the Hochstetter epithelial wall. Rather embryos and newborn indicates that the origin of a harelip cannot be uniform. the three following forms may be seen: a. There exist form’s of harelip in which the formation of the cleft is complete and no signs can be seen that an epithelial wall ever existed. Their origin is in an overlong perb. There are harelips with soft tissue bridges. sistence of the epithelial wall and its too late absorption. These originate c. There are forms which may have their origin in harelip cysts. They may be secondary, i.e., by tearing off, give in the region of the epithelial wall. cause to a harelip. E. P. S. The Use of Fascia 1949.
in Jaw-Surgery.
K. Morgenroth.
Deutsche
zahnarztl.
Ztsehr.
4: 350,
In using bone transplants in the region of the jaw it is often necessary to perform a preliminary operation. Unfavorable blood supply conditions have to be improved in the wound itself and in This may be achieved by fat implantation, A disits vicinity by excision of scar tissue. advantage of the fat implantation which is under tension i.s that often small drops of fat ooze out through the skin suture preparing the way for possible infection. The author tries to prevent this by covering the transplanted fat with fascia from The fascia is being fastened with a continuous suture over the wound under the thigh. the undermined skin. Such a fascia gives excellent service in the operation of parotid The fascia forces the parotid excretion to go its normal way into the oral cavity fistula. without making previous x-ray treatment for the depressing of the secretion necessary. H. R. M.
OF
CURRENT
563
LlTERATURE
For the complete cleft of the palate, either single or bilateral, the author prefers the Veau type of operation if the cleft involves the anterior part of the palate and the alveolar process. In cases of single palatal cleft and associated single harelip, the Veau type of closure of the anterior half of the palate and of the alveolar process is combined in a single stage with a Mirault type of repair of the harelip. In eases of bilateral complete cleft palate and bilateral harelip, the bilateral Veau operation and the bilateral repair of the harelip sometimes can be done as a single operation, or the anterior part of the palate and the lip can be repaired on one side only at one time, and the same operation done on the other side after an interval of from ten days to two weeks. Often, the decision whether to use the ‘single-stage or the two-stage method is not made until the defect of one side has been repaired. If the operation has proceeded smoothly thus far and if the child is taking the anesthetic well and is in good condition, one can proceed with the repair of the defect on the other side; otherwise, it is better to defer the remainder of the repair until later. To the Genesis
of Harelip.
G. Tijndury.
Pratt.
oto-rhino-laryng.
10: 146, 1948.
The author defines the meaning of “harelip” and rejects the classical teaching of the origin of the harelip. The embryonic face is not based on the existence of processes and clefts which have to be joined, but only on few little apparent superficial grooves. If a real cleft is found it is usually a pathologic condition. In the transformation of the nasal grooves into the nasal tubes, the sides of the nasal groove come together and slowly cover the groove from behind toward the front. On this side of the suture originates the Hochstetter epithelial wall. Under normal conditions the epithelial wall in its anterior part is pierced again by mesenchyme and disappear.s entirely. A human embryo of 13 mm. S.S.L. is being described with a left-sided The comparison of both sides indicates that the harelip, the right side being normal. mentioned fissure is the primary cleft originating in consequence of a lack of build-up The comparison with other observations of older of the Hochstetter epithelial wall. Rather embryos and newborn indicates that the origin of a harelip cannot be uniform. the three following forms may be seen: a. There exist form’s of harelip in which the formation of the cleft is complete and no signs can be seen that an epithelial wall ever existed. Their origin is in an overlong perb. There are harelips with soft tissue bridges. sistence of the epithelial wall and its too late absorption. These originate c. There are forms which may have their origin in harelip cysts. They may be secondary, i.e., by tearing off, give in the region of the epithelial wall. cause to a harelip. E. P. S. The Use of Fascia 1949.
in Jaw-Surgery.
K. Morgenroth.
Deutsche
zahnarztl.
Ztsehr.
4: 350,
In using bone transplants in the region of the jaw it is often necessary to perform a preliminary operation. Unfavorable blood supply conditions have to be improved in the wound itself and in This may be achieved by fat implantation, A disits vicinity by excision of scar tissue. advantage of the fat implantation which is under tension i.s that often small drops of fat ooze out through the skin suture preparing the way for possible infection. The author tries to prevent this by covering the transplanted fat with fascia from The fascia is being fastened with a continuous suture over the wound under the thigh. the undermined skin. Such a fascia gives excellent service in the operation of parotid The fascia forces the parotid excretion to go its normal way into the oral cavity fistula. without making previous x-ray treatment for the depressing of the secretion necessary. H. R. M.