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This new edition of an excellent monograph covers its subject in detail. The text is representative of the general current thinking of contemporary British plastic surgeons. The purpose of the book is to present the steps necessary to produce acceptable speech in the child with a cleft palate. An excellent historical review of cleft palate therapy is included. Methods of closure are discussed under three headings: (1) closure by median suture (Von Langenbeck), (2) flap methods of closure, and (3) methods involving compression of the upper jaw (Brophy) with the inherent poor results. A closure that will produce physiological function is the present aim. The Wardill "four-flap" method is the most popular operation in use by the British plastic surgeons. It is often combined with a Wardill pharyngoplasty. Fracture of the hamular processes is usually carried out. The advantages of this method is that it not only gives midline closure
Cleft Palate and Speech. JAMA. 1955;157(8):692. doi:10.1001/jama.1955.02950250066047