Surgery for Speech

Children conceived during a blustery February and gestated during a stormy spring are more apt to have cleft palates and harelips than children created while weather is more temperate. This is a fact which Professor William Ferdinand Petersen of the University of Illinois discovered while compiling a treatise on The Patient & the Weather.

To such defectives, especially to their parents. Professor Harold Stearns Vaughan of Columbia University, a surgeon-dentist who has been repairing the gaping roofs of mouths for 30 years, last week gave good cheer. In the American Journal of Surgery he pointed out that their defective speech is primarily due to the failure of the soft palate to close off and separate the nasopharynx (space back of the nose) from the oropharynx (mouth part of the throat). Consequence of such failure is that air which should escape from the mouth, during the enunciation of consonants, vibrates through the nasal cavity and escapes through the nostrils.

Apart from stitching a harelip (best done when a child is two to six weeks of age), and wiring a cleft palate (best done between the second and third year), Dr. Vaughan has devised a method of lengthening the soft palate so that it can effectively close the upper part of the throat, resulting in clear speech.

His procedure is to cut a W in the roof of the mouth. The outside bars of the W begin back of the molars, go forward along the gums to the bicuspids. From there the inner bars of the W go inward across the roof of the mouth until they meet at a point midway between the molars. This cutting makes three gores in the roof of the mouth. With a blunt knife Dr. Vaughan separates the two rear gores from the palatine bone. This allows him to slide the soft palate, to which they are attached, backward to the rear wall of the throat. The loose flaps of membrane he then stitches to new positions on the palatine bone. By the time they grow onto the bone and new membrane grows over the bared portions of the bone, the soft palate has learned to prevent consonantal sounds from rumbling into the nose. Then speech is perfectly clear.

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