The folded pharyngeal flaps, which were created at Kyoto University, and other types of pharyngeal flaps at other hospitals were compared using cephalometric radiographs taken at rest and during phonation of /si/.
The results were as follows:
1. The length of pharyngeal flap demonstrated no significant differences between folded pharyngeal flaps and other pharyngeal flaps.
2. The thickness of the folded pharyngeal flap was found to be thicker than that of other pharyngeal flaps (p< 0.01).
3. The position of the base of the pharyngeal flap was not significantly different between the folded pharyngeal flap and other pharyngeal flaps. The nasal midpoint of the folded pharyngeal flap was higher than that of other pharyngeal flaps (p< 0.05). The nasal midpoint of the folded pharyngeal flap was consistent with the point of the velopharyngeal closure.
4. The size of the folded pharyngeal flap was larger than that of other pharyngeal flaps.
5. The angle of the soft palate against the nasal floor plane showed no significant difference between the folded pharyngeal flap and other pharyngeal flaps.
The folded pharyngeal flap had a clear advantage over other pharyngeal flaps in terms of velopharyngeal closure.

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The purpose of this study was to determine whether levator veli palatini muscle activity can be elicited by simultaneous changes in oral air pressure and nasal air flow rate when a speech appliance is in place. The previously operated on cleft palate patients were selected as subjects. The subjects were found to have normal articulation and resonance with a speech appliance in place but showed hypernasality without it. Speech appliances worn routinely by the subjects were modified by drilling a hole in the veritical center of the pharyngeal bulb. The air flow rate into the nasal cavity through the opening in the bulb was systematically altered by changing the circular areas of the opening in the bulb from the occluded condition to 4mm in diameter and then to 7mm in diameter. Electromyographic activity of the levator veli palatini muscle was measured with changes in the nasal air flow rate and oral air pressure that were induced by the alteration of the circular area of the opening at the bottom of the bulb. To evaluate the effect of the nasal air flow rate and oral air pressure on levator veli palatini muscle activity, multiple regression analysis, using levator veli palatini muscle activity as the criterion variable and the nasal air flow rate and oral air pressure as explanatory variables, was carried out after standardization of all the obtained data.
Multiple regression analysis revealed that the nasal air flow rate may affect levator veli palatini muscle activity more dominantly than oral air pressure. The results indicate that aerodynamic variables of nasal air flow and oral air pressure might be involved in he neural control of speech production in individuals wearing a speech appliance, even if they exhibit velopha ryngeal incompetence when a speech appliance is not used.

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We have performed 110 cases of Furlow palatoplasty since 1988. As the speech results of 52 of these cases could be estimated, a comparison study of Furlow and Pushback palatoplasties was carried out. The overall results were as follows:
1) Velopharyngeal closure function of the Fur low group was significantly better than that of the Pushback group. (p<0.1)
2) Rate of articulat ory failure of the Furlow group was also significantly lower than that of the Pushback group. (p<0.05)
3) Rate of palatiniz ed articuback group. (p<0.01)

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To clarify the amount of formation of granulation tissue on the mucoperiosteal defect after palatoplasty in cases applied an artificial skin (atelo-collagen), we applied atelo-collagen to one side of the mucoperiosteal defect and nothing to the other side in 7 cleft palate infants. We investigated the changes in the normal direction on the defects as compared to the preoperative condition. It was clarified that the concavity of the side applied atelo-collagen was less than that of the non-application side. In addition, the height of the palatal mucosa recovered more quickly when atelo-collagen was applied.

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An investigation was carried out to determine the incidence of cleft lip and/or palate (CL/P) among Japanese 65.207 infants born between Jan.1,1992 and Dec.31,1992. Ninety infants (0.138%) were found to have abnormalities; approximately 1.38/1000 live births. Of these infants, the number of CL, CLP, and CP were 31 (34.4%),34 (37.8%), and 25 (27.8%) respectively.

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