The underdevelopment of the maxilla is frequently seen in post operative cleft lip and palate patients, and this fact can 136 expected mainly for the cleft lip and palate repair. Accordingly, young growing rabbits were operated in four series. The operations were practiced respectively with closure of physiological cleft lip, unilateral periosteal elevation of premaxillo-maxilla, closure of physiological cleft lip with bilateral periosteal elevation of premaxillomaxilla, and partial resection of lateral side of upper lip. The growth of facial skeleton was compared between the experimental and the control group in the cephalometric study, and the occlusion and the alterations of bone surface in premaxillo-maxilla were observed. The results were as follows.
1. The slight forward growth disturbance and the downward overgrowth of the upper and lower jaw were found in the group of closure of physiological cleft lip. In one case out of 8 cases the jaw relationship was disturbed, resulting in anterior cross-bire.
2. There were slight deviati o n of the snout towards the operated side in the group of unilateral periosteal elevation of premaxillo-maxilla. The forward growth disturbance of the maxilla and the slight forward growth disturbance of the mandible as same as the downward overgrowth of the both jaws were found in this group. The occlusion was quite normal except that the bone surface on the operated side showed cribriform and thickening, and partial fusion of premaxillo-maxillary suture were found.
3. The severe forward growth disturbance of the both ja w s, and the downward overgrowth of anterior part of the mandible were observed in the group of closure of physiological cleft lip with bilateral periosteal elevation of premaxillo-maxilla. There were anterior cross-bite from early stage after operation in this group. Only one case out of 11 cases showed normal occlusion.
4. The findings of the forward growth disturbance of the both jaws were observed in the group of partial resection of lateral side of the upper lip, but there was no deviation of the snout in this group.

View full abstract

Young growing rabbits were operated by unilateral premaxillo-maxillary periosteal elevation, and the dried crania were observed in various post-operative periods. The bone surface of the premaxilla on the operated side showed cribriform 1 week after operation and the same changes were found on the maxilla 3 weeks after operation. With the lapse of experimental periods, these findings became more distinctly. Further, the partial fusion were seen on the premaxillo-maxillary suture of the operated side 4 weeks after operation, and the thickening were observed on the bone surface of the operated side 2 months after operation. The thickening became more strongly with the lapse of the time.
In order to inspect the reas on of the changes of the bone surface on the operated side, the same operation were carried out, and the bone and the surrounding tissue were observed by angiographic and histological study. The distribute density of blood vessels of the bone and the surrounding tissue on the operated side were higher than that on the unoperated side in any experimental periods. The periosteum on the operated side were 10times thicker than that on the unoperated side 1 week after operation. The thickness diminished with the lapse of the time and that was almost same on the both operated and unoperated side 4 months after operation. The osteoblasts diminished remarkably on the unoperated side 4 weeks after operation, but they were found on the operated side 6 months after operation. Through all experimental periods the bone trabecula on the operated side was thinner than that on the unoperated side. The bone surface was smooth on the unoperated side, but rough on the operated side 4 weeks after operation.
From the above findings, the changes of the bo n e surface on operated side were suspected that there were caused by the hypervascularization, thickening of the periosteum, and increase and long time existence of osteoblasts.

View full abstract

This paper reports acoustic investigations about the mechanism of nasal snort production after cleft palat es surgery. The results are as follows.
1. Sound spectrographic p atterns of nasal snort yield the following results. Acoustic pattern produced by oral sound was characterized about 85 to 1,000 Hz, nasal cavity speech pattern was found to be sever in the range of the baseline, and to grew decresent toward high frequency rang e, and the pharyngeal cavity speech pattern was found to be stronger in the range of the baseline, and to scatter about a higher compass than nasal ones.
2. Nasal snorts were grouped into 3 calsses. I (periodicc frequency), II (non-per i odic frequency), and type III (mixture, ).
3. More type II, and fewer type III appeared in voiced consonants than in unvoiced ones.
4. There were more type II, and fewer type III in fricative sounds than in plosive ones.
5. The acoustic element of nasal snort requires over 60 msec of continuous time, and over 3,100 Hz of sound energy so as to recognize it clearly.

View full abstract

We must recognize general consciousness and attitude of th e people to the patients with cleft lip and/or palate. So we selected five typical regions of Nagoya district and investigated with questionairs.
Results
1) Most people knew the term "Cleft Lip and/or Palate" but didn't understand the true impediment very well. For example, the poor condition on oral function was understood a little, but the mental affliction was not understood at all.
2) The information at source of this term "Cleft Lip and/or Palate" was get mainly from seeing the patients in the neighborhood and from reading the printed matters. In order to promote the best way to get the general counsel, we must consider how to use the mass communication.
3) Public health services didn't have activity to give the informational source, so we desire some policy in this field.
4) As regards to the etiology of this malformation, many people considered that heredity is one of the important factors or the cause is unknown. On the other hand, there are signs that some superstitions for this disease are still alive.
5) In the therapy of this desease, many people expect for the possibility of fine healing, so we must make every effort to the repletion of the therapeutic technique.
6) About attitude to the patients. Most people make effort not to give the patients handicap. It is moral support for the patients.
7) Most people recognize that the patients had handicap on social life, particularly personal relationships, marriage and employment.
8) Most people don't know that health insurance apply to treatment of this desease. So we hope for the more public information of medical administrative organ.
9) They expect to make more effort to the repletion of the special hospitals, economical support and basic research of this disease.

View full abstract

[in Japanese]

View full abstract