. Chirurgie opératoire, pour les étudiants et les praticiens . envoyé une fente du processus alvéolaire, et ceci peut varier d'une étroite, fissure incomplète à un large, openspace; il peut être unilatéral ou double, et est généralement associé à 98 TÊTE ET VISAGE. Fente palatine. S'il n'y a pas de fente du palais dur, la fente du processus théalvéolaire se termine au foramen palatin antérieur : point de thétération du processus palatin de chaque côté et de l'os intermaxillaire. Si la fente dans le processus alvéolaire implique des bothsides, l'os intermaxillaire, qui est continu avec l'avant du vomissant, peut b

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. Operative surgery, for students and practitioners . sent a cleft of the alveolar process, and this may vary from a narrow, incomplete fissure to a broad, openspace; it may be unilateral or double, and is usually associated with 98 HEAD AND FACE. cleft palate. If there is no cleft of the hard palate, the cleft of thealveolar process terminates at the anterior palatine foramen: themeeting point of the palatal process of either side and the inter-maxillary bone. If the cleft in the alveolar process involves bothsides, the intermaxillary bone, which is continuous with the frontof the vomer, may be placed forward in advance of the rest of thealveolar process, especially if cleft palate is also present; so that itand the corresponding portion of the npper lip seem to be suspendedfrom the point of the nose. In this case the lower tegumentary partof the septum of the nose is absent, the soft parts which representthe middle part of the lip being continued directly with the tip ofthe nose. This advancement of the intermaxillary bone is due to the. Pig. 33.—Harelip with (A) Advanced Intermaxillary Portion. unrestricted forward growth of the vomer, which is not inhibited asis normally the case when it is joined to the palatal processes. Ifthe cleft is confined to one side of the alveolar process and the hardpalate, the intermaxillary bone, as it is carried forward by the growthof the vomer, is apt to become markedly twisted upon its long axis, so that its anterior surface, instead of being directed forward, looksalmost directly toward the normal side of the face, presenting itsprominent sharp lateral edge anteriorly. The intermaxillary seg-ment may be entirely absent, as already mentioned. Cleft Palate.—The presence of a longitudinal fissure which mayinvolve the hard or soft palate or both. It is caused by a failureof the palatal processes of the superior maxillary processes to meet CONGENITAL DEFORMITIES OF THE FACE. 99 in the middle line and coalesce. In these cases the b

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