We measured soft palate, posterior pharyngeal wall and lateral pharyngeal wall of 14 children with congenital velopharyngeal incompetence and 8 children with submucous cleft palate using cineradiography during phonation of /a/.
Then we compared congenital velopharyngeal incompetence with submucous cleft palate. The results were as follows.
1) Soft palate length, levator eminence length, nasopharynx depth, lateral pharyngeal wall distance, the ratio of levator eminence distance to nasopharynx, depth, posterior pharyngeal wall moving distance, soft palate mobility and soft palate thickening had no diagnostic significance differences between congenital velopharyngeal incompetence patients and submucous cleft palate patients.
2) Submucous cleft palate children had thinner soft palates than those with congenital velopharyngeal incompetence (p< 0.01).
3) Passavant's ridge appeared during phonation of /a/ in three congenital velopharyngeal incompetence children and 1 submucous cleft palate child. The ridge height was 5.0 mm, and the ridge position was 7.0 mm below the palatal plane.
4) The soft palates of children with congenital velopharyngeal incompetence slightly lengthened during phonation of /a1, but those of children with submucous soft palate slightly shortened (p< 0.001).
5) Children with submucous cleft palates showed betterateral wall mobility than those with congenital velopharyngeal incompetence (p< 0.001).
6) There was no correlation between soft palate moving distance and that of lateral pharyngeal wall between congenital velopharyngeal incompetence children compares to those with submucous cleft palate.
7) Cougepital velopharyngeal incompetence was caused by short soft palate, deep nasopharynx, anterior bias of levator palati muscle, incompetence of mobility, atrophy of muscle, etc., or by combination of any tow or more of the above.

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After pushback palatoplasty, various methods are used for covering palatal wound. This time, we used oxidized regenerated cellulose (ORC) for dressing exposure of maxilla and for packing relaxation incision wound insted of Sofratulle gause we had previously used. This proceduce was performed on 10 patients with cleft palate or submucous cleft palate. The results show the following advantages of ORC: 1) effective for the inhibitation of bleeding,2) unnecessary to be removed,3) closely applied to wound,4) supressing bacterial infection,5) no complications after operation.

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The authors presents a modified procedure of V-Y columella elongation using Bilateral clefts. We employed a subcutaneous pedicled tissue flap under the V-flap for augumentation of a flat and wide nasal tip. This procedure has been used on 15 cases of bilateral cleft lip between 1986 and 1990.
Columella lengthening and nasal tip plasty proved reliable in all these cases. However, the lower part of the columella became narrow and a third linear scar remained on the median upper lip.

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