Dental News - Little progress recorded in historical cleft lip and palate treatment

Dental Tribune USA

Sun. 12 October 2014

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NEW YORK, N.Y., USA: The Cleft Palate–Craniofacial Journal recently presented a historical review of what Western doctors and scientists knew about defects known as cleft lip and palate. The authors of the review sought to verify that treatment and surgical techniques for these malformations were largely esthetic and unchanged until the 19th century.

When the printing press was invented in the mid-1400s, it had an unexpected effect on the practice of Western medicine. With the creation of moveable type, works by ancient and medieval doctors could be preserved, and contemporary surgeons were able to share details about their methods. The authors of this review went back to these early medical, surgical, and dental records to find those that mentioned the harelip, or cleft lip, and cleft palate.

They found that cleft lips and palates were recorded in ancient texts and art in all cultures reviewed. It appears that some form of cleft lip treatment was being undertaken in the Middle Ages. The technique mainly involved sewing the edges of the defect together to reconstruct the lip. Cleft palate “surgery” consisted of merely covering up the defect, possibly because it was seen as impossible to treat.

Despite the increase in published medical texts from the 16th to the 18th century, Western doctors corrected functional and esthetic lip defects in much the same way as their predecessors in the Middle Ages. Surgeons generally did not want to operate on the mouth because they could not control the pain and feared hemorrhaging. They also did not appear to understand the origins and development of these malformations. Infections set in easily, and medical practitioners had few options for fighting them.

Cleft palate surgery was not possible until the 19th century. Along with the technical advances of this era, surgeons had more ways to limit infection and pain in their patients. Not until this time were fundamental changes recorded in the treatment of cleft lip and cleft palate.

The Cleft Palate–Craniofacial Journal is an international, interdisciplinary journal reporting on clinical and research activities in cleft lip/palate and other craniofacial anomalies, together with research in related laboratory sciences. It is the official publication of the American Cleft Palate–Craniofacial Association (ACPA).

(Source: Cleft Palate–Craniofacial Journal)

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