Nasopharyngeal closure requires synchronized movement of the soft palate with sphinctering the nasopharyngeal port by the surrounding musculature in the lateral and posterior walls.
In the treatment of cleft palate patients, it is quite essential to elucidate the underlying complex mechanism by monitoring measurement of the nasopharyngeal components.
Therefore, an attempt has been done to measure pressure in the nasopharynx in these patients with the aid of strain gages placed on the pharyngeal bulb of the speech aid. In this paper, a preliminary experiment to determing pressure-strain relationship of the transducer and the influence of temperature variation to the strain gage in the nasopharynx with a report obtained from one patient.
1) Press ure-strain relationship was linear at 18C and 35°C, and there no was significant difference in them.
2 ) Nasopharyngeal temperature monitored in four patients varied between 34°C; to 36°C at the resting position of the soft palate with no significant change during function.
3) Pressure of the soft palate and lateral and posterior wa lls during various activities could be monitored individually and simultaneously without interfering the function of these sites.
4) Pressure during swallowing was higher than that of phonation. Higher p ressure was needed for plosive consonants /pa/, /pi/, /pu/, /pe/, /po/ than for vowels
.5) In addition to pressure change, time relationship o f the starting point of voice with the starting point and the maximum piont of pressure wave could be measured from the recording.
6) The method proved to be a valuable means to provide objective assessm ent of the nasopharyngeal function and be useful in determing diagnosis and treatment as well as for evaluation in cleft palate patients with nasopharyngeal incompetncy.

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The mechanism of nasopharyngeal closure was studied in 6 cleft palate patients with nasopharyngeal insufficiency by measuring pressure of the soft palate, posterior wall and bilateral walls with the technique described in the previous report.
1) The pressure of the soft p alate changed from low to high with much variation in each individual, while the posterior wall pressure was low with much deviation. There was remarkable variation with the pressure of the lateral walls, indicating characteristic movement of the lateral walls in various phonations.
2) Significant difference was found between inward movements of the lateral walls in three patients and two of them didn't show synchronized patterns in the pressure change of the lateral walls during phonating of vowels and consonants.
3) There was no comm on relationship of pressures for 5 vowels, between voiced and voiceless sounds, and for the influence of vowels to consonants.
4) There was a tendency that th e pressure for consonants was higher than that of vowels and that it was lowest in the nasal sounds. A tendency that the pressure of plosive consonants, fricative consonants, vowels and nasal consonants decrease in this order demonstrated clearly in the lateral walls.
5) The pressure of hard blowing was higher than that of soft blowing and the pre ssure of water swallowing was higher than that of saliva swallowing.
6) Nasopharyngeal closure mechanism of swallowing which required high pressure could be distinguished clearly from other functions, but blowing and phonation were not distinguishable.
7) The starting point of pressure wave occured 325 msec before and maximum point of pressure wave was observed 92 msec after the beginning of voice on average.
8) The start and the maximum points of pressure wave o f plosive consonants occured earlier than the other sounds, and in plosive consonants, they were observed earlier in voiceless sounds than in voiced sounds.

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In recent years numerous advances have been made in the rehabilitation of cleft lip and/or palate patients. But up to the present the care and the survey for dental diseases of cleft lip and palate patients are hardly dane.
Authors h ave done the survey of caries incidence in deciduous teeth of cleft lip and palate patients.
The subjects were 171 out patients in the Tohoku University Dental Hospital with cleft lip and/or palate, ages ranging from 1 to 6 years.
The results were as follows:
Until age 4 years, the number s of carious teeth have increased markedly and decay has extended from ont surface to other surfaces. After 4 years old, the numbers of carious teeth have indicates plateau, but decay has extended slightly into other healthy surfaces.
Deciduous teeth were grouped into four parts, na mely upper and lower anterior region and bilateral upper and lower posterior teeth, to compare the caries incidence of each individual regions. In the upper anterior region, the incidence of carious teeth have increased rapidly until the age of 2 years. In the upper and lower posterior regions, carious teeth have increased slightly and lineal with age.

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The safe endotracheal anesthesia is required for the surgeon to perform, without any disturbance, the fine, delicate plastic operation of the cleft lip and palate.
However, from the anesthesiological standpoint, there is the difficulties which ensue from the facts 'that the anatomy of oral ca vity and the neighbOuring structure is anomolous and that the upper airway is involved in the operation field. The anesthesiologist has to solve the problems how to maintain the airway in the induction, maintainance and recovery of the anesthesia and how to give each of the surgeon, the anesthesiologist himself and the nurse the room where they can work without disturbing the others.
In order to give the better anesthesia for the plastic operation of cleft lip and palate, we had made some devices in the anesthetic induction, the endotracheal tube, the fixation of the tube, and the position of the anesthesiologist and the anesthetic apparatus. According to the methods, over 2000 cases of anesthesia were given to the cleft lip and palate surgery with satisfied result. The details of the anesthetic procedures were described with the reflections.

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