The operation for cleft palate was presented for the first time comprehensively, according to Dorrance, in 1816 by von Graefe, the founder of modern plastic surgery. The operation which is known today as the Langenbeck procedure was described in 1861 by von Langenbeck.
An extensive literature has accumulated since these early operations for cleft palate, and but a small amount of it pertains to the functional results after treatment.
Reports on the phonetic outcome in a group of cases may be satisfactory individually, but great difficulty is encountered in comparing the results in one group with those in another. The difficulties of judging the phonetic results of other investigators arise because, in the first place, the observations made for each report depend on the auditory sense, which is individually variable. Second, there are so many factors involved in speech that a method of anaylsis satisfactory to one observer might not