The history of treatment of cleft lip and palate

The history of surgery of cleft lip and palates reaches as far backwards as the prechristian era to 390 B.C. when for the first time a cleft lip was closed successfully in China. Although Egyptian and Greek medicines developed to a remarkable degree, no descriptions of cleft operations have survived. In the middle ages operations on cleft lip have been several times described. A successful operation on a cleft palate did however not occur until 1816. This can be explained by the fact that cleft palates were thought to be secondary to syphilis, but also because without anaesthetic this operation was extremely painful and difficult. Graefe in 1816 [20a] and Roux in 1819 [49] published the first satisfactory results. After the introduction of chloroform cleft surgery made remarkable progress. The development of cleft surgery has been chronologically described and finally the present state of affairs is discussed.