If there be any difficulty experienced in accomplishing this, owing to the presence of cicatricial thickening of the parts, the latter must be excised in gutterlike fashion (author), and the mucous membrane be freed from its attachment until it comes into place readily.
Care should be especially exercised in lining the angles of the newly formed mouth.
The subsequent contraction of the rima oris following the above operation is prevented only by lining the angle with mucous membrane, healing into place by first intention.
Fig. 255. Fig. 256.
Dieffenbach Method.
Rose Method.—Rose advises sewing a small triangular flap of mucous membrane into each angle to overcome the contraction.
Heuter Method.—Heuter employs an artificial mouth of hard rubber tubing of a size corresponding to the new mouth made in the form shown in [Fig. 257].
This ring is forced into the oral opening and the patient is instructed to wear it for some weeks after the operation or until the tissues have become softened and elongated and will no longer retain it.