This investigation was carried in order to evaluate the difference on the morphological craniofacial patterns due to surgical methods and various types of clefts.134 patients with clefts of the lip and palate operated at the almost same time by one surgeon were compared with 30 non-cleft children by x-ray cephalometry.
The results suggested that
(1) There were no significant differences when data were compared for the surgical methods of cheiloplasty.
(2) There were no significant differences when data were compared for the types of clefts lip.
(3) Cleft of the palate and palatoplasty were recognized to effect on the morphological craniofacial patterns. Anterioposterior maxillary retardation in the patients with unilateral clefts of the lip and palate and with isolat e d clefts of the soft and hard palate were revealed. Whereas, the retardation in the patients with isolated c lefts of the soft palate was slight.
(4) The profiles of the patients with unilateral clefts of the lip and palate and with isolated clefts of the soft and hard palate were quite clearlily concave from the intermaxillary relationship. The profiles of the patients w ith isolated clefts of the soft palate were slightly concave.
(5) There was no differences of effects on the cranial base as to the types of clefts except isolated clefts of the soft and hard palate. The small cranial base angle of isolated clefts of the soft and hard palate was presumably caus ed by nasal septum isolation from the palatine process, that is, palatine bone.

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The present study was designed to clarify the aerodynamic changes after unified velopharyngeal plasty. Aerodynamic analysis made on 17 patients suggested the followings.
(1) The nasal resistance tended to decrease gradually until 6 months after operation.
(2) The nasal resistances of 12 adult subjects were quite different from those of 5 non-adult subjects.
(3) No significant difference was noticed in the nasal resistance between inahalation and exhalation.

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Many methods for the correction of whistling deformities after repairs of bilateral cleft lips hays been reported. After denuding the depressed center portion of the upper lip, we have used muscular pedicle island flaps from the lateral lip segments and brought them together medially on the denuded portion to increase the height of the tubercle of the lip. Results are most satisfactory.

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An attempt was made to rear cleft palate mice which can be used for the study of maxillofacial development.
Dexamethasone (3mg/kg) was given subcutaneously to ddN mice on the 11th day of gestation to produce cleft palate ones.
Since no mice with cleft palates can live under-the care of the dam, they were experimentally reared by hand feeding under four conditions.
Four conditions in this experiment were as follows:
1. cow's milk under conventional condition
2. sterilized cow's milk in Isolator
3. the curd in stomach under conventional condition
4. sterilized the curd in Isolator
Regardless hand reari n g under four conditions was performed respectively, mice with cleft palates did not live more than 5.5 days. It seemed very diffcult to rear mice with cleft palates induced by dexamethasone. Other experimental animals may be essential for the success of this experiment.

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Treatment of Cleft lip and cleft palate cases must achieve early improvement of the form and function of the oral cavity, thereby helping the patients secure normal articulation. Further, to prevent any defect that may result and to induce normal growth, treatment should not be limited merely to surgery. It is necessary and important that comprehensive treatment covering the psychological, pediatric, linguistic, and orthodontic fields be planned and implemented. This is obvious from our observation of a 16-year-old girl with cheilognathoschisis and a cleft palate who was suffering from emotional and psychological problems because of uraniscolalia and unsuccessfully treated cleft lips, as she had not undergone comprehensive treatment. Her utterance and psychological conditions before and after surgical operation were observed at certain time intervals by means of an articulation test, MMPI test, MAS test, and the Taken test for diagnosing parent-child relations.
The results are summarized below:
1. In the MMPI tests given before and after surgery, the indexes Pa, Pt and Ma scored high. Pa is an index for excessive sensitivity and a suspicious disposition; Pt indicates apprehension, fear and obsession; Ma sho w s the degree of activeness of thought and behavior, and the level of general activities.
2. It is dangerous to attribute these anomalies solely to surgical operation. It was suggested that true solution cannot be achieved without accurately grasping and improving background factors, such as, for e x ample, parent-child relations, guidelines for the future, and social environment.
3. This case has pointed out to us 'physicians providing medical service the importance of psychological guidance as well as medical care at initial diagnosis and each step of treatment thereafter.

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