Journal of Japanese Cleft Palate Association
Online ISSN : 2186-5701
Print ISSN : 0386-5185
ISSN-L : 0386-5185
Volume 27, Issue 3
Displaying 1-11 of 11 articles from this issue
  • 2002 Volume 27 Issue 3 Pages e1-
    Published: 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
  • Mihoko NAKANII, Hitomi SINOHARA, Hiroe TUSIMA, Yosie EBATA, Takahiko M ...
    2002 Volume 27 Issue 3 Pages 269-278
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    This paper, in order to offer good cares of mothers who delivered cleft lip babies and/or palate ones, investigates the actual situation of them under obstetrics hospitalization.
    A total of 145 mothers who visited the hospital after delivery were given que stionnaires.
    The following results were obtained: 44.8% of the mothers with cleft lip babies and/ or palate babies did not have knowledge about cleft lips and/or palate.6.8% of the mothers knew, before the delivery, that a fetus had cleft lips and/or palate.53.1% of the mothers were forbidden to see their children immediately after delivery; 31.7% of the mothers were informed about the details of these conditions later than 2 days after delivery.
    Very few mothers (8.3%) were given definite information about these symptom s by special doctors.30.3% of the mothers were not minutely instructed how to breast feed.
    Around 70% of the mothers were not given any information about nursing and associatio ns of parents' when they were leaving the hospital. Only 37.9% of the mothers were satisfied with the care and treatment by the medical staff during hospitalization. This research shows that it is necessary to give the follo wing to the mothers at the time of the first examination of for surgical medical treatment.
    1. Detailed explanation regarding cleft lips and/or palate.
    2. Breast-feeding instruction.
    3. Childcare instruc tion regarding long-term medical treatment.
    4. The information to support a medical treatment life.
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  • Keiichi ARAKAKI, Hajime SUNAKAWA, Hiroyoshi HIRATSUKA, Teruyo SHINYA, ...
    2002 Volume 27 Issue 3 Pages 279-285
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    Recently in the treatment of cleft lip and palate patients, it has been reported that good velopharyngeal competency and articulation is related to the timing of the surgery. We have obtained successful results in velopharyngeal competency in 90% of our cases. It is considered that many preoperative factors (e. g. cleft type and from, movement of the pharynx, the skill of the surgeon and the postoperative training of the patient) are related to the results of velopharyngeal competency, Additionally, the length of the training period is an important factor. In the present study, cleft type, cleft width, and velopharyngeal distance, as related to the time required to achieve velopharyngeal competency, was investigated.
    1. Relationship between cleft width (CW) and the period of time required to achieve velopharyngeal competency (VPC-T).2. Relationship between pharyngeal depth (VP-D) and the period of time required to achieve velopharyngeal competency (VPC-T).3. Relationship between the preoperative evaluation and the period of time required to achieve velopharyngeal competency (VPC-T).
    The results were as follows:
    1. A relation with the acquir ed period of velopharyngeal competency was recognized for cleft width and pharyngeal depth.
    2. A relation between the preoperative evaluation and the period to acquire velopharyngeal competency was seen, and the period to acquire velopharyngeal competency was comparatively shorter as for the thing made good by the preoperative evaluation.
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  • Kanji NOHARA, Takashi TACHIMURA, Yoshinori FUJITA, Takeshi WADA
    2002 Volume 27 Issue 3 Pages 286-291
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    The purpose of this study was to examine if the result of electromyography (EMG)examination of the levator veli palatini muscle (LVP) is repeatable. Three speakers with normal function, who were estimated to show consistent velopharyngeal function (VPF), were used as subjects. EMG of LVP was recorded in twice with different electrodes for the same tasks: blowing at maximum intensity, and phonation. The EMG activity was expressed as a percentage ( %peak EMG) relative to the maximum value of EMG activity observed throughout one examination, to reduce the influence of sensitivity and placement of electrodes. The correlation coefficient of values of %peak EMG between the first and the second examinations, for all subjects during the speech tasks, was significant. This result indicated that %peak EMG of LVP may be reproducible, and suggested that %peak EMG of LVP might be useful to evaluate VPF change sequentially.
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  • Report on an Investigation in Children with Clefts of the Hard and Soft Palate
    Toshiko NAKAJIMA, Atsushige YOSHIKAWA, Nobuyuki MITSUKAWA, Ken-ichi YA ...
    2002 Volume 27 Issue 3 Pages 292-296
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    Originally the Hotz's plate was invented for patients with clefts of the lip and plate. At St. Mary's Hospital, children with clefts of the hard and soft palate also wear the Hotz's plate. To ascertain the influences on speech development through the use of the Hotz's plate before palatoplasty, we compared the differences in the rates of occurrence of compensatory misarticulation between groups with and without the Hotz's plate in children with clefts of the hard and soft palate. There was no statistically significant difference between the two groups. The results indicated that the presence of velopharyngeal incompetence or an oronasal fistula after palatoplasty influences the occurrence of misarticulation.
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  • Toshikazu ASAHITO, Kazuto TERADA, Kazuhiro ONO, Minoru YAGI, Tadaharu ...
    2002 Volume 27 Issue 3 Pages 297-305
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    For cleft lip and/ or palate patients, effective treatment by a team approach performed by the medical specialist is indispensable. In 1991, a Cleft Palate Team was est ablished at Niigata University Dental Hospital, and since then,778 patients have been registered for management in a total care system by the Team, until December 31,2000.
    We have already reported a clinical and statistical evaluation of Cleft Palate Team activities regarding primary cases, in 1998.
    The purpose of this study was to conduct a clinical and statistical evaluation of Cleft Palate Team activities by analyzing 360,10-to-18-year-old patients, including not only primary cases but also secondary cases.
    The results were as follows:
    1. The percentage of primary cases was 64.2, and that of those who lived in Niigata prefecture was 88.6. The rate of the primary cases was more than that of secondary cases for patients under 16 years old.
    2. There were few o pportunities to consult operative dentistry and endodontics, fixed prosthodontic dentistry, and removable prosthdontic dentistry.
    3. Mean initial visits of secondary cases were at 6Y6M to oral-maxillofacial surgery, at 4Y1M to speech clinic, at 3Y5M to preventive dentistry, at 4Y2M to pediatric dentistry, and at 5Y6M to orthodontics.
    4. The management situation of patient was favorable, and it was suggested that effective treatment has been performed smoothly by the Cleft Palate Team approach.
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  • Toru ARAI, Kazuhiro ISHII, Shuichi MORITA, Kooji HANADA, Kazuhiro ONO, ...
    2002 Volume 27 Issue 3 Pages 306-324
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    Objectives: The purpose of this study was to investigate effects of two-stage palatoplasty combined with Hotz' plate on craniofacial development in complete unilateral cleft lip and palate (UCLP).
    Materials and Me thods: This semilongitudinal study was based on a comparison of craniofacial development between two UCLP groups: a two-stage group, consisting of 29unilateral cleft lip and palate (UCLP) patients (19 males and 10 females), whose cleft palates were closed with two-stage palatoplasty combined with Hotz' plate (soft palatal closure at 18months, and hard palatal closure at 6 years); and a one-stage group, consisting of 28 UCLP patients (18 males and 10 females), whose cleft palates were closed with one-stage palatoplasty within 2 years. Eighty-seven headfilms (54 for males,31 for females) from the two-stage group, and 89 (58 for males,31 for females) from the one-stage group, were divided into five age groups (6,8,10,12, and 14 years), according to age of subjects. Additionally, each group was divided into two groups according to gender. After the lateral headfilms of each subject were traced, and the tracings were superimposed on Sella of SN line,24 variables were measured. The mean and standard deviation of each parameter in each group at different ages were calculated, and data from both groups were compared for each sex. Further, male and female average facial diagrams in both groups at each age were constructed, respectively, to investigate differences in the craniofacial growth pattern.
    Results: In SNA, both male and female two-stage groups showed larger va lues in all age groups, especially in six-, eight-, and ten-year-old males. Furthermore, ANB values for two-stage group members of both sexes were consistently larger (1.5 degrees) compared with members of the one-stage trial, especially at 6,8,10, and 12 years of age. Conversely, male, one-stage group-members' values decreased over time. Furthermore, female, one-stage group members showed negative values, from the sixth year onward.
    Conclusion: The findings in this study showed tha t craniofacial development in UCLP subjects with two-stage palatoplasty combined with Hotz' plate was better than that with one-stage palatal closure, indicating that this procedure for palatal closure could be advantageous for craniofacial development.
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  • Shigeo KYUTOKU, Koji YASUI
    2002 Volume 27 Issue 3 Pages 325-332
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    It is difficult but most important to achieve the goals of cheiloplasty in the first surgery, in order to create a balanced and symmetrical lip and philtrum column, as much as possible. Since 1992, we have done 29 primary cheiloplasties with a modified Millard's procedure, utilizing a denuded C-flap for philtrum column reconstruction. From a small series of long-term follow-up of these philtrums, a primary denuded C-flap procedure is proved to provide long-lasting symmetry, and we could say that “Not only God can make Cupid's bow.”
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  • Comparison of Early Surgery with Non-Early Surgery
    Yasutaka KUBOTA, Masaki MATSUURA, Akira SUZUKI, Tomoko TANIGUTI, Yasuh ...
    2002 Volume 27 Issue 3 Pages 333-338
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    We investigated the effects of cheiloplasty that was performed before 60 days after birth on the maxillofacial growth in infants with unilateral cleft lip (UCL) and unilateral cleft lip and palate (UCLP). The subjects were divided into two groups: A and B; the cheiloplasty in group A was performed before 60 days after birth (37.4±14.2 days in UCL, and 32.5±11.9 days in UCLP), and that in Group B was performed after 61 days after birth (1 13.9±28.9 days in UCL, and 103.6±31.0 days in UCLP). The maxillofacial growth of the patie nts was evaluated using lateral cephalograms that were taken at age 7. There were no significant differences in the values of S-N, N-Palatal plane/S-N, N-Ans/S-N, Ans-Pns/S-N, ∠S⋅N Ans, ∠SNA, S-Pns/S-N, Cd-Gn/S-N, Cd-Go/S-N, ∠SNB, and gonial angle between the two grou ps. These results suggest that cheiloplasty that is performed before 60 days after birth has no disadvantage in terms of the resulting maxillofacial growth at age 7 of patients, compared with cheiloplasty that is performed after 61 days after the birth.
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  • Effects of Two -Stage Palatoplasty on Maxillofacial Development
    Kazuhiro ONO, Kanako OCHI, Shuichi MORITA, Akihiko IIDA, Makoto HAYATS ...
    2002 Volume 27 Issue 3 Pages 339-349
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    The purpose of this study was to observe maxillofacial morphology of a pair of monozygotic twins with cleft lip and palate (Child 1) and cleft lip (Child 2) longitudinally, and to evaluate the effects of two-stage palatoplasty on maxillofacial development. The findings were as follows: 1. Compared with Child 2, th e position of the maxilla in Child 1 was already located posteriorly before the hard palate closure. Moreover, the posterior portion of the maxilla was located upward.2. Ther e was no difference in length of the hard palate between Child 1 and 2 before the hard palate closure. A little inhibition of maxillary growth was recognized in Child 1 operated on the hard palate closure.3. Clockwise ro tation of the mandible was observed in Child 1.4. The antero-posterior relationship between the maxilla and m andible was almost good in both Child 1 and 2. These findings s uggest that two-stage palatoplasty delaying hard palate closure does not severely inhibit growth of the alveolar portion of the maxilla, resulting in the achieving of a normal dental arch. In two-stage palatoplasty, this may cause a good inter-maxillary relationship owing to the help of morphological adaptation of the mandible, even if the position of the maxilla is posteriorly located.
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  • Application of a Rigid External Distraction System (RED System)
    Akimichi MIYAZAKI, Tetsuya YAMAGUCHI, Norimasa OKAFUJI, Shunsuke YUZUR ...
    2002 Volume 27 Issue 3 Pages 350-365
    Published: October 30, 2002
    Released on J-STAGE: February 19, 2013
    JOURNAL FREE ACCESS
    Recently, distraction osteogenesis has been used for patients with hypogrowth of bones. Distraction osteogenesis is a technique of lengthening hypogrowth bones with a mechanical distraction device to regenerate bone and soft tissue.
    This is a clinical report on a bilateral cleft lip and palat e patient with severe undergrowth of the maxilla, using maxillary distraction osteogenesis by a rigid external distraction system (RED system). The patient was a girl 9 years and 11 months old, with malocculusion due to a bilateral cleft lip and palate. Although the lst stage treatment used a facial mask due to the acceleration of the maxillary forward growth, the maxilla still showed extreme undergrowth. Therefore, we changed our treatment plan to maxillary distraction osteogenesis by a RED system, combined with a mandibular set back osteotomy and genioplasty.
    Maxillary movements were evaluated using lateral cephalometr ic analysis, and endosseous metal implants were inserted into maxillary bone as a marker. During maxillary distraction, maxillary forward movement was less than the extension distance of the distraction screw. The amount of distraction screw extension was 34 mm, but the marker moved only about 7.5mm, caused by tooth movement and sway of the head-frame. The problem with the RED system was deformation of the distraction hook and head-frame movement because of heavy tension of the scar tissue in this cleft lip and palate patient. However, the position of the maxilla after distraciton osteogenesis was stabilized, and relapse was hardly observed. As a consequence, stable occlusion and profile improvement could be obtained by this treatment.
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