Abstract
We have presented our basic concept of the surgical management of the cleft palate patients during the period from birth to preschool age.
The purpose of this studyis to arise the role of operater on the cleft palate repair and the related problems.
Here, we have discussed the following three problems by focusing on the cleft palate repair.
1. How to operate the cleft palate to have satisfactory speech.
2. Necessity to check up on dental caries and ear drum.
3. Consideration for dento-alveolar and maxillary growth.
In order to maintain the satisfactory speech function and the maxillary dental arch growth, we have been utilizing a palatal mini-mucosal flap method in cleft palate repair.
This method made it possible to maintain not only satisfactory speech function but also proper growth of maxillay dental arch length.
In this study, we have demo nstrated our surgical method of lengthening of the soft palate and obtaining the mobile palate.
In order to support the postoperative management of dental and ear problems, it is also neccesary to cheek-up the dental caries and the ear drum during the physical examination at the out patient department.
Among the factors of detrimental influence in maxillary growth follwing cleft palate repair, we have close-up the effect of wound contraction and scar contracture along the incision line. It is our opinion that the wound contraction in the sture line of the hard palate may cause narrowing of the maxillary dental arch width during early postoperative period and then was fixed by scar contracture.
On the other hand, the maxillary dental arch length was not obviously influ enced by the wound contraction and showed the progression on the development.
The protection of scar contaction at the site of pterygomaxillary junction may lead to the growth of maxillary dental arch length in proper way.
Avoiding the scar contracture at the sit e of pterygomaxillacy junction seems to be necessary to consider in cleft palate repair.
The operator also seem s to have the role of a promoter to support the total management of the cleft palate patients in this period.
