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Volume 2 (1977)
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Volume 2, Issue 2
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Tadashi KITAJIMA1977 Volume 2 Issue 2 Pages 1-12
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSAlthough the true causes of the suppression of the maxilla ry growth after cleft lip repair is not known aclurately,the increase in the pressure of the lip after surgery has been regarded as one of the important causes.
The pressure of the lip was measured with use of a pressure transducer utilizing a strain gauge in 54unilateral cleft lip patients just before and after surgery under general anesthesia. The results were as followings.
1) In most cases, increase in the pressure and the tightness of the lip was noted postoperatively.
2) The alteration of the pressure of the lip after surgery was varied with the widt h and the type of cleft lip. Almost all cases in complete cleft lip and palate were increased in the pressure and the tightness of the lip, though several cases in incomplete cleft lip were decreased.
3) The rotation-advancement flap operation had a tendency to facilitate the increase in the pressure of the lip more than the triangular flap operation.
4) The increased pressure and tightnes s of the lip just after cleft lip repair was decreased at 10 months later, and adaptation was completed. This indicates that the period of actively affecting the maxillary growth is within 10 months after cleft lip repair. Therefore maxillary growth retardation after palatoplasty might be caused by other factors.View full abstractDownload PDF (8433K) -
Masaki Abe, Yasushi Ohashi1977 Volume 2 Issue 2 Pages 13-20
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSIn our previous report, the enlargement of the thymus gl and was shown to be noted a high rate in chest radiographs of the cleft lip and palate patients at the age of 3 months. In the current study, further investigation was done in a total of 42 patiets with a particular attention to its change in the following one or two years.
1. In the radiographice xamination performed prior to the cheiloplasty, the thymic enlargement was observed in 32 patients (76.2%) aged 2-5 months. This incidence was more or less similar to that shown in the provious report.
2. In 23 patie nts who underwent palatoplasties at the age between 11 to 21 months, the thymic enlargement was seen in only 34.8%, w hich was significantly lower (p<O.0 5) than its incidence before the cheiloplasty which was as high as 82.6% in the same patients.
3. In the majority o f cases with the enlarged thymu s group, the thymic image occupieda pproximately 60% of the thorax at the 2nd and 4th intercostal spaces, whereas its value in patients with no thymic enlargement was less less than 50%.
4. After the consultation with pediatricians, A CTH (5u/days x 7days) was injected in half of 32 cases with the abnormal thymus before the cheiloplasty and in 3 of 8 cases prior to the palatoplasty. Two patients received its injections prior to the both cheilo and pa. latoplasties. On the other hand, patients with no enlargemeot in the thymus gland prior to the cheiloplasty showed no abnormality in chest radiographs taken before the palatoplasty.
5. Thus, the enlarged thym us gland showed the tendancy to reduce in size with age in cleft lip and palate patients.View full abstractDownload PDF (5560K) -
Tomonobu Goto, Taichiro Motomura, Tamotsu Mimura, Tadashi Miyazaki1977 Volume 2 Issue 2 Pages 21-26
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSThis study was undertaken to clarify the strength of velopharyngeal closure during phon ation, blowing and swallowing. Then, we made to compare the strength in cleft palate patients with in normals.
Subjects were composed of 10 normals and 9 cleft palate patients. Cleft palate patients were divided into two groups according to the fiberscopic findings; A-group with the complete velopharyngeal closure during blowing and B-group with incomplete one.
The measurement of the strength was made in speech, blowing and swallowing by using the balloon catheter which was inserted to vel opharyngeal port with transnasal approach.
In normals, velopharyngeal closure was the strongest in hard blow ing, then in pressure consonants, finally in vowels. The strength in swallowing was almost as equal as in hard blowing.
Cleft palate patients had a weak velopharyngeal closure. But A-group showe d a differentiated velopharyngeal closure as same as in normals.
The results suggest that velophar yngeal function is distinguished in various actions after the complete closure, and that cleft palate patients are inferior to normals even though they had got the complete velopharyngeal closure.View full abstractDownload PDF (2804K) -
Yasuko Miyanoshita, Takeshi Katsuki, Hideo Tashiro1977 Volume 2 Issue 2 Pages 27-33
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSRecently, among various cleft palate speech problems, much interest is given to palatalization of dental and alveolar sounds. From January 1972 to December 1974,96 cleft palates had been treated surgically in this department.
Of the se,11 patients (11.5 per cent) demonstrated palatalization of dental and alveolar sounds. Type of cleft, occlusion, and fistula formation were assumed to be etiological factor of this phenomenon. However, analysis of the cases disclosed that these were nothing to do with palatalization.
On the other hand, it was found out that, prior to appearance of palata lization, these patient produced substitution by velar sounds or substitution by glottal, lip and glottal stop for dental and alveolar sounds. The patients without this substitution had no palatalization.
Therefore, it can be concluded that palatalizat ion has intimate relationship with previous articulation.
Treatment for palatalization was carried out mainly with the aid of patient's visual and ta ctile sensation. In certain patients, infant denture or Hyne's temporary training plate was attempted and these turned out effective.View full abstractDownload PDF (5039K) -
Yutaka Wakui, Michio Sugiyama, Shuichiro Sawa, Kooji Hanada, Tatsuo Fu ...1977 Volume 2 Issue 2 Pages 34-39
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSModified appliance of speech-aid (palatalizer) was used for the treatment of the glottal stop in the cleft palate patients. In short time the patient could articulate/K/, and speech was much improved. The palatalizer was effective not only to shallow the vault, also to shorten the distance between the back of the tongue and palate. The appliance was able to keep the movement of the tongue from back-ward. Using the palatalizer, the patient get a clue for the sense of touch and movement in articulating /K/ and could could artificially produce the palatlized articulation.View full abstractDownload PDF (15006K) -
Junko Imai, Tokuzo Matsuya, Tamotsu Mimura, Juntaro Nishio, Kaoru Ibuk ...1977 Volume 2 Issue 2 Pages 40-45
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSWe devised a new procedure of pharyngeal flap operation named VELOPHARYNGEAL FIXATION TECENIQUE. On this technique, we attempted to make two small rings with connection of the levator palati and the constrictor pharyngeus muscles.
The nasal mucous membrane of the soft palate was elongated with Z plasty and then was supplemented with the flap from the retropharyngeal wall. The soft palate consequencely was attached to the posterior pharyngeal wall with wide base.
This operation was performed on tw enty patients for the last five years. The shrinkage of the flaps was not seen in the patients who were followed up for more than three years ago.View full abstractDownload PDF (3772K) -
Kimie Ohyama, Takeshi Sekiguchi, Takashi Ohyama1977 Volume 2 Issue 2 Pages 46-55
Published: December 25, 1977
Released on J-STAGE: February 19, 2013
JOURNAL FREE ACCESSThe purpose of thise of this paper is a proposal for systematic appr oach in caring for the cleft lip and palate patients.
The follow ing items are discussed:
1. The sysems of registration and protocol on the cleft lip and palate patients.
2. The relation between speech therapy and occlusion.
3. The relation between surgery and occlusion.
4. The propriety of orthodontic treatment in primafy den tition.
5. The change of occlusion with pubertal/ growth.
6. The criteria for extraction of teeth.
7. The determination of the number of teeth involved in retention.
8. The consideration on prosthodontic treatment.
We concluded that a breakdown of ex act professional identities and the development of new communication with each specialist are required for the successful team approach on the cleft lip and palate patients.View full abstractDownload PDF (18475K)
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