22q11.2 deletion syndrome is a congenital disorder associated with palate abnormalities, congenital heart disease, distinctive facial features, developmental delay, and a variety of other congenital abnormalities. Submucous cleft palate (SMCP) and congenital velopharyngeal insufficiency (CVPI) are more common palate abnormalities than cleft palates. Velopharyngeal closure (VPC) in the 22q11.2 deletion syndrome group (22q group) was compared with that in the non-22q11.2 deletion group (control group), and treatment methods were investigated.
　　Subjects comprised 21 patients in the 22q group (7 with SMPC, 14 with CVPI) and 20 patients in the control group (9 with SMPC, 11 with CVPI) who presented to our hospital with the chief complaint of inarticulate speech and who were available for spoken language evaluation. Cleft palate verbal examination, lateral cephalograms, and fiberscopy were used to examine the nasopharyngeal form and function, and rhinolalia aperta before and after surgery were compared to investigate treatments.
　　Palates were shorter and pharyngeal cavities were deeper in the 22q group than in control group, but there were no clear differences in palate movement. Rhinolalia aperta was slightly more severe before pharyngeal cavity surgery and it took longer after surgery for rhinolalia aperta to improve in the 22q group.
　　A short palate and deep pharynx are considered to impact rhinolalia aperta. Cephalograms did not reveal any notable differences in palate movement, but decreases in motion endurance may have resulted from decreased muscle tone. Pharyngeal flap surgery was primarily conducted for patients with CVPI. SMCP patients were treated by Furlow’s technique or the pushback technique for bundle formation, and if rhinolalia aperta is of moderate or higher severity, pharyngeal flap surgery should also be considered.

　　This study retrospectively evaluated the records of 5 high-risk patients with jaw deformities whose orthodontist hesitated to perform orthognathic surgery. Among these 5 patients, 2 were Jehovah’s Witnesses and thus refused blood transfusions, 2 were diagnosed with psychiatric disorders, and 1 reported a history of bisphosphonate administration. For the 2 patients who refused blood transfusions, the estimated blood loss was 65 and 70 ml during intraoral vertical ramus osteotomy and double-jaw surgery, respectively. No blood transfusions were performed for either patient. For the second patient, surgery was canceled once because consent for blood transfusion was not obtained. The patient with a history of bisphosphonate administration was treated using sagittal split ramus osteotomy and bone fusion was normal. Of the patients with psychiatric disorders, 1 patient with depression underwent double-jaw surgery without any postoperative complications. The other patient who was diagnosed with depression and schizophrenia also underwent double-jaw surgery. Postoperatively, few treatments were administered, and previous treatments were terminated. Overall, our experience with such patients suggested that close interdepartmental coordination was important for carefully planning and implementing treatment policies to manage high-risk patients requiring orthognathic surgery.

　　As linear orbital floor fractures often entrap the inferior rectus muscle and soft tissue into the fracture line, emergency restoration is recommended to treat the oculocardiac reflex and avoid ocular movement disorder due to inferior rectus muscle necrosis/contracture.
　　We report a case in which a foreign body granuloma occurred late in the lower eyelid after emergency repair of linear orbital floor fracture.
　　A 7-year-old girl presented to our hospital with left facial pain/headache, nausea, and vomiting. Left eye upward ocular movement disorder was observed. Computed tomography and magnetic resonance imaging revealed a left orbital floor linear fracture with deviation/deformation of the inferior rectus muscle due to soft tissue entrapment. Emergency surgery was performed 9 hours after injury, and the upward ocular movement improved and there was no persistent diplopia. One year and 4 months later, redness, swelling, and entropion of the lower left eyelid developed. A foreign body granuloma of the lower eyelid was found strongly adhering to the palpebral conjunctiva and orbicularis oculi muscle. After granuloma excision, the lower eyelid entropion improved promptly.
　　Emergency restoration surgery requires additional careful and delicate manipulation for immediate management of the injured eyelid.

　　Introduction：We have diagnosed and operated on more than 200 craniosynostosis cases. Based on comparison of our data with those from previous publications, we found that patients with craniosynostosis in Japan receive surgical intervention at a later phase of pathological development than patients in other countries. The publications presented at the 2015 Craniofacial Conference held in Chiba, Japan also revealed the same tendency.
　　Materials and cases：Some craniosynostosis cases are difficult to diagnose correctly if the shape of the head is small. We present two such cases here. One is a case that was untreated under the diagnosis of microcephaly, and the other is a case treated when the child was relatively young, but delayed development was found during follow-up.
　　Conclusion：Based on our experience, we consider early surgical intervention to be very important to improve and reduce developmental delay. We need to inform pediatricians who screen infants and children on how to better diagnosis craniosynostosis in order to implement earlier treatment.