In order to clarify the appearance of facial deformities in unoperated patients with bilateral cleft lip, three dimensional analysis and measurements of the surface area on various parts of the external nose and upper lip were perfomed using facial plaster models, which consisted of 27 cases of complete bilateral cleft lip (group A),9 cases of one side complete and the other side incomplete cleft lip (group B),7 cases of incomplete bilateral cleft lip (group C) and 10 control infants.
The results were as follows.
1. Lateral displacements of the nasal tip, median points of the base of the columella and mucocutaneous ridge on the prolabium tended to be smaller in the control group and groups A and C, but a slightly large lateral displacement to the incomplete cleft side was observed in group B. Median points of the bas e of the columella and mucocutaneous ridge on the prolabium in each group displaced anteriorly, and espe cially in group A, anterior and upper displacement of these points were predominant. In addition, the height from the median point of the base of the columella to that of mucocutaneous ridge on the prolabium was smaller in the cleft groups as compared with control group, which was the minimum in g r oup B.
2. The nasal ala in the cleft groups showed inferior and lateral displacement and the width of the nasal ala was greater as compared with the control group. Although no distinct difference in each group w a s observed in the upper and lower positioning of the mouth angle, the width of the mouth angle in grou ps A and B was greater than that in the control group. The depth between the nasal ala and mouth angle was the smallest in group A.
3. The width of the upper point of cleft ridge on the prolabium showed no distinct difference among the cleft groups, however, it was located the most anteriorly in group A. The upper point of cleft ridge in the laterolabium positioned more posteriorly on the complete cleft side than that on the incomplete cleft si d e, and the width of the upper point of the cleft ridge on the laterolabium was the greatest in group A.
4. The surface area of the nasal dorsum was larger in the cleft groups as compared with the control group, however, the surface area of the nasal ala showed no remarkable difference in each group. The su rface area of the prolabium was the largest in group A, and the surface area of the philtrum in the control group followed. However, the surface area of laterolabium was the smallest in group A, showing a signifi c ant difference as compared with the control group and group B.
5. The nasal ala and the upper points of the cleft ridge on the prolabium and laterolabium were located almost symmetrically in the control group and groups A and C, however, these points in group B s howed a greater lateral displacement on the incomplete cleft side rather than on the complete cleft side. Although the surface area of the nasal dorsum was greater on the complete cleft side as compared with the incomplete cleft side in group B, the difference from right and left in the surface area of other sites was relatively small in any groups examined.

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To make a phlegmon of mouth floor without infection, carrageenin solution was injected into mouth floor of pregnant ddY mice. Another females, at the same time of pregnancy, were given subcutaneous injection of carrageenin solution as a control.
The results obtained were as foll o w s;
1. In the group of carrageenin inflammation of mouth floor, incidence of cleft palate was 3.0% (the 10th day of pregnancy),0% (the 11th day) and 2.3% (the 12th day).
2. In the group of subcutaneous injection, no incidence of cleft palate at the 10th,11th and 12th day of pregnancy.
From the above results, it may be suggested that cleft palate can be developed by carrageenin induced phlegmon of mouth floor during pregnancy.

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Advancement of the maxilla by Le Fort I osteotemy and closure of oro-nasal fistula by bone grafting of the alveolar cleft were simultaneously conducted in 10 patients with postoperative cleft lip and palate patients showing the disharmony of the upper and lower jaws and anterior closs bite. morever, in cases of marked disharmony of the upper and lower jaws mandibular retroplacement by the sagittal splitting technique of the ramus was performed, also in cases showing to the said region was carried out, and in caces using the tongue flap bone grafting to the anterior cleft of the hard palate was performed. This surgical technique not only prevents postoperative relapse, which is frequently observed after the Le Fort I osteotomy of cleft lip and palate, and makes reductoins in mental, time, and economic loads by a reduction in surgical frequency, but forms a good shaped alveolar ridge, resulting in easy prosthetic treatment for the alveolar cleft, and has many merits.

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Hotz type orthopedic plate is widely used in early treatment for cleft lip and palate. The purpose of this study is to know how long it is possible for CLP babies to wear the plate and how effective the plate is to overcome feeding difficulties which CLP babies have.9 cases of BCLP,16 cases of UCLP and 21 cases of CP were investigated.
The results were as follows:
1. It was possible for all cases except 3 with poorly developped swallowing mechanism to wear the plate until age 6 months when lip plasty is usually carried out.
2. Feeding speed (m//min) was significantly improved after wearing the plate in all 4 BCLP cases,4 of the 5 UCLP cases and 3 of the 5 CP cases.
These results show the plate is v e r y effective in overcoming feeding difficulties of CLP babies and in promoting physical development just after birth. Therefore, Hotz type orthopedic plate is recommended in early treatment for cleft lip and palate.

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Hotz type orthopedic plates have been used for early treatment of cleft lip and palate in our hospitals since Febrivary,1985. We studied the early effects on maxillary growth where the plates were worn almost continuously until the first operation in 10 cases of UCLP and 6 cases of BCLP.
The results were as follows:
1) The early effects in UCLP w ere narrowing of the cleft lip and palate, parallel running of both medial edges of the segments, shifting and uprighting of both the segments, and flattening of the high palate.
2) The e arly effects in BCLP were narrowing of the cleft lip and palate, parallel running of both the medial edges of the segments, shifting and uprighting of both the segments, flattening of the high palate, straightening of the deviated vomer, and development of the vomer toward the oral cavity.

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In this report we presented results obtained from 80 subjects by the use of Cornell Medical Index Health Questionnaire (CMI) and Yatabe-Guilford character test (YG-test).
The results were as follows:
1. Four subjects(5%) were fonud abnormal by both CMI and YG-test.
2. Sixteen (20%) were found abnormal by either CMI or YG-test.
3. Sixty (75%) were judged normal by both psychological test.
It may be concluded that the percentage to find abnomaliti e s in those methods was comparable to general group. But it will be still important to keep some of those mothers, as a group without judged normal, carefully consulted about their psychological status.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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