I ABSTRACTS I

BARD CosmaAN, M.D., EDITOR

NATIONAL COMMITTEE

Oscar E. Beder, D.D.S. Stephen Glaser, M.D. Norman J. Lass, Ph.D. Andrew Blitzer, M.D. Alexander Goldenberg, D.D.S. Dennis O. Overman, Ph.D. Robert M. Briggs, M.D. John B. Gregg, M.D. Dennis M. Ruscello, Ph.D. William Cooper, M.D. Jerry Alan Greene, D.V.M. F. T. Sporck, M.D. Jack C. Fisher, M.D. Daubert Telsey, D.D.S.

INTERNATIONAL COMMITTEE

Paul Fogh-Andersen, M.D., Copenhagen, Denmark Seiichi Ohmori, M.D., Tokyo, Japan Jean L. Grignon, M.D., Nevilly, France Anthony D. Pelly, M.D., Sydney, Australia Jose Guerrero-Santos, M.D., Guadalajara City, Helen Peskova, M.D., Prague, Czechoslovakia Mexico H. Reichert, M.D., Stuttgart, West Germany Stewart B. Heddle, M.D., Ontario, Canada W. H. Reid, M.D., Glasgow, Scotland Junji Machida, D.D.S., Shiojiri City, Japan E. Schmid, M.D., Stuttgart, West Germany Francesco Minnervini, M.D., Rome, Italy Jean Claude Talmant, M.D., Nantes, France

Beninceton, I. C., and C1irroRrp, T., An injec- the inconveniences. A great deal of patience tion technique for palatal defects, ]. is required to properly communicate with Prosth. Dent., 47: 414-418, 1982. these patients. (Goldenberg) To further retention of prosthetic devices obturating palatal defects, advantage is taken FuKupa, T., Goto, T., Wapa, T., and Mrya- of undercuts, Extension of borders are made ZAKI, T'., Maternal mentality for the chil- with flexible arms into the undercuts without dren with clefts, /J. Jap. Cleft Palate Assoc., undue impingement, and the prosthesis can 6(2): 55-62, 1981. be tolerated by the patient. Impressions are _ The Osaka University Cleft Palate Team taken with rubber base impression material, 'has presented the orientation class to the utilizing a syringe technique. The elasticity of - --ijthers to inform more about the rehabili- the material allows for great latitude in- tation program of the cleft and/or palate impression taking. The excellent quality and ° and to promote their co-operation in the pro- elasticity of this material has proven to be a gram. A series of questionnaires were filled great asset where impingement into undercut out by 100 mothers of children, aged from 2 areas aids retention greatly. (Goldenberg) to 4 years. Most of the mothers reported that they had a little knowledge about clefts, and CuEn, M. S., Upagama, A., and DranE, J. B., had known the word "harelip" and had met Evaluation of facial prostheses for head repaired cleft lip before they had cleft babies. and cancer patients. J. Prosth. Dent., It was a severe shock for them to meet their 46: 538-544, 1981. babies for the first time, and many of them Patients forced to wear facial prostheses, - considered to kill the babies, themselves, or reveal criticisms with relation to color, fit, both. Though most of them could realize the stability, adhesive quality. Apparently, adhe- rationale for treatment of the cleft, many sives could be improved. Present day knowl- wanted more delicate counseling especially edge of the chemistry of the materials, skin for future management of their problems. tone, color shading, are open to constant in- (Machida) vestigation. Patients do have to understand the technical problems, and in doing so, ac- GrEwirtTz, J. M., CaspE, W. B., Dauey, T. J., cept the inadequacies, and shrug off some of and Dt Carro, S., Airway obstruction in 288 ABSTRACTS 289

infectious mononucleosis in young chil- CLAP groups when compared with the CLA dren, C/in. Pediatr., 21: 370-372, 1982. ones. The long axis of the upper deciduous Upper airway obstruction is known to be a incisor was inclined lingually in the CLA and serious complication of infectious mononucle- CLAP groups than in the unilateral CL. The osis in older children and adolescents, but its craniofacial morphology was very similar in occurrence in children under three years of the three groups of the incomplete unilateral, age has not been documented except for the the complete unilateral and the incomplete publication of two case reports, both prior to bilateral CLAP. (Machida) 1950. In a recent two-month period the au- thors encountered three children, under three Gourp, H. J., and CarparELLI, D. D., Hear- years of age, with symptoms and signs of ing and Otopathology in Apert Syn- upper airway obstruction secondary to infec- drome, Arch. Otolaryng., 108: 347-349, tious mononucleosis due to hyperplasia of the 1982. lymphoid tissue in the oropharynx and naso- The authors studied the otologic and au- pharynx. (Glaser) diometric information from 19 patients who GoTo, M., Multivariate analysis of craniofa- had phenotypic characteristics of type I Apert cial morphology in infants with clefts of syndrome. In five there were velar anomalies the lip and/or palate by means of roent- ranging from bifid uvula to incomplete cleft- genographic cephalometry, J. Jap. Cleft ing. No important differences were found clin- Palate Assoc., 6: 1-28, 1981. | ically between patients with and without ve- lar anomalies. Frontal cephalometric radio- Roentgen cephalograms of 278 infants with graphs were available on 18 patients. Results unoperated cleft lip with or without cleft pal- from this study indicate that individuals with ate were analyzed to reveal the effects of the Apert syndrome are at risk for long term cleft types on the craniofacial morphology. middle ear disease and conductive hearing The numbers of the cases in the cleft types loss, from birth. The hearing loss is primarily were 36 incomplete unilateral cleft lip (CL), the result of stiffening of the middle ear system 46 incomplete unilateral cleft lip and alveolus from otitis media and its sequellae and the (CLA), 41 complete unilateral CLA, 11 in- otopathology is similar to that with cleft pal- complete bilateral CLA, 21 incomplete uni- ate. Contrary to middle ear disease with cleft lateral cleft lip, alveolus and palate (CLAP), palate, that with Apert syndrome does not 84 complete unilateral CLAP, 12 incomplete resolve with growth or long term manage- bilateral CLAP, and 27 complete bilateral ment. Serial cephalometric studies of patients CLAP. Angular and linear measurements with Apert syndrome showed alterations from the lateral and postero-anterior roent- which contributed to a diminution of the genocephalograms, body height, body weight nasopharyngeal space which becomes more and age were used for the multivariate anal- severe as the individual matures. Potentially ysis of the craniofacial morphology. Some of this unusual growth may cause deleterious the results were as follows. From a stepwise effects upon Eustachian tube function. discriminant function analysis of thirty three (Gregg) variables, thirteen were selected as the best discriminators. In those, the length of the cranium and the heights of the maxilla were Hear, D. P., HeEunms, P. J., DinwipptE, R., and well affected by the general body size. Orbital, Mattuew, D. J., Nasopharyngeal air- nasal and maxillary arch widths were wider ways in Pierre Robin Syndrome, J. Pe- in the CLAP groups than in the CLA ones. diatr., 100: 698-703, 1982. The nasal and maxillary arch widths of the Nasopharyngeal airways have been assessed CLA groups were broader than that of the in the management of infants with severe incomplete unilateral CL. A deficiency of Pierre Robin syndrome. In 12 such infants the maxillary forward growth was found in the positioning and subsequent maintenance of CLAP groups except the complete bilateral these tubes were found to be important in CLAP one. The downward growth of the ensuring adequate relief of the airway ob- posterior maxillary base was inhibited in the struction. In five infants measurements of 290 Cleft Palate Journal, October 1982, Vol. 19 No. 4 lung mechanics demonstrated the benefits of three; both complete, both incomplete, and nasopharyngeal tube placement and con- one side complete and the other incomplete. firmed the observed improvements in cy- The- plaster models were measured on several anotic episodes, heart failure, electrocardi- points of the lip, nose and eye. When com- - ograms, and arterial gas tensions. In a retro- pared with the control group of ten normal spective survey of 40 infants with Pierre Ro- infants, the experimental groups showed fol- bin syndrome, failure to thrive was found to lowings. The distance between the entokan- be significantly correlated with the severity of thion was longer. The deviation of.the vertical airflow obstruction. This failure to thrive was length of the measured points was little. The reversed in the infants managed with naso- anterior deviation of the columella base and pharyngeal tubes in comparison with an age- the midpoint of the cupid's bow were much matched group nursed while prone. The lack prominent due to the protrusion of the pre- of significant complications with the nasopha- maxilla. The sideward deviation of the meas- ryngeal airway and its acceptability to nurs- ured points, especially of the transverse width, ing staff, patients, and their parents suggest was remarkable, but the symmetry of the that this method deserves more widespread was good. The deviation of the nose tip, col- use in Pierre Robin syndrome and perhaps umella base, and the midpoint of the cupid's in other situations in which high upper bow were very small except in the group of respiratory tract obstruction is predominant. one side complete and the other incomplete. (Glaser) The height of the nose tip was not lower, but it gave the impression of a saddle nose. It IrEzor, J., Sone, S., Hicasninara, T., Mor- might be suggested that the forward displace- moto, S., Yorota, K., Onnminr, H., Fu- ment of the columella base, the midpoint of cHinatTA, H., and NisHinara, H., Chest the cupid's bow, and the cheek made this- x-ray appearance of the of in- impression. (Machida) fants and children, Nipp. Act. Radiol., 40: 702-710, 1980. Jorarnson, R. J., Suariro, S. D., Sarmas, C. The thymic shadow on frontal chest x-ray F., and LEvIN, L. S., Intraoral findings films of 1,000 cleft lip and/or children without and anomalies in neonates, Pediatr., 69: cardiopulmonar disease, taken before cleft op- 577-582, 1982. eration was analyzed. Though the age ranged Examinations of the oral cavities of 2,258 between 1 month to 12 years old, 753 were neonates demonstrated a high frequency of under 2 years old. The shadow was found gingival and palatal , leukoedema, and bilaterally in 603, in right in 158, in left in median alveolar notches. Alveolar lymphan- 136, and none in 103 cases. In younger than gliomas, ankyloglossia, and commissural lip 3 years old, it was bilateral in more than 60% pits were seen relatively frequently. A differ- of them, with the younger the more. The ence in the frequencies between the races and shape and site of the shadow was classified sexes was documented for most of the condi- and discussed in detail. In most cases it ap- tions. (Glaser) peared in the upper mediastinum. The size was expressed in relation to the thoracic size. KousseErr, B. G., McTonnmacuIE, P., and The number of cases with large thymus de- Hapro, A., Autosomal recessive type of creased with the age. (Machida) whistling face syndrome, Pediatr., 69: Kawa, T., Snirn, T., ABE, M., Yamamoto, 328-331, 1982. T., H., AoK1, K., KanamorR1, A report of concordant monochorionic, K., Kamva, Y., Manasre, H., YosHIDa, diamnionic like-sex twins with whistling face S., HaTtroRI, Y., and Asov, M., A study syndrome is presented. The diagnosis was on morphology of bilateral cleft lip, J. based on the characteristic facies with prom- Jap. Cleft Palate Assoc., 6: 29-50, 1981. inent supraorbital ridge, sunken eyes, telecan- Facial plaster models were made on 25 thus, short nose and colobomata of the nos- infants with unoperated bilateral cleft lip and trils, long philtrum, high narrow palate, and palate, the cleft lip being subdivided into marked with puckered and ABSTRACTS 291

an "H" shaped cutaneous dimpling on the with incisive artery) technique in push- . The hands showed symmetrically back operation, J. Jap. Cleft Palate Assoc., clenched fingers with camptodactly and ulnar ~6(2): 1-1, 1981. deviation. The feet'demonstrated mild bilat- It is inevitable for postoperative velopha- eral talipes equinovarus. HLA studies to de- ryngeal closure to obtain sufficient length of termine the zygosity of the twins showed dis- the palate in the primary cleft palate . cordance in HLA haplotypes which indicated Pushback operation with VY designs of three dizygosity. The pedigree analysis showed nor- flaps or four has been widely practiced for mal nonconsanguineous parents and no other this purpose. But in the patients with alveolar family members had the syndrome. The find- cleft, insufficient material in the anterior part ings support the existence of an autosomal frequently causes the oro-nasal . A recessive type of whistling face syndrome. method to cover the anterior cleft with an (Glaser) incisive flap was described. A long triangular mucoperiosteal flap, with its base just palatal MorraEL1, J. R., An improved obturator for to the upper deciduous incisors and its apex a defect of the nasal septum, J. Prostk. 5mm caudal to the incisive foramen, was Dent., 47: 419-421, 1982. prepared and elevated. The incisive artery was elongated by severing the attached con- An obturator for a nasal septum is de- nective tissue. The flap with vascular bandle scribed, where hygiene, irritation, and crust- was shifted onto the suture line of nasal layer ing, are bothersome problems. A hard, dense in the anterior region, and fixed by mattress acrylic material will reduce possibility of odor suture. This method provides complete pala- retention. Where surgical correction is contra- tal closure as well as sufficient pushback for indicated, this technique provides a proper unilateral complete cleft. (Machida) substitute. (Goldenberg)

Mrroma, T., Honyo, I., Harapa, H., and Fu- MontcomEry, G. L., BALLANTINE, T. V. N., JIMURA, S., Evaluation of velopharyngeal KriEimnman, M. B., WaricHt, J. C., and closure by computerized tomography RrEynoLDs, JANET, Ruptured branchial (CT), J. Jap. Cleft Palate Assoc., 6: 51-57, cleft presenting as acute in- 1981. fection, Clin. Pediatr., 21: 380-383, 1982. Validity of computerized tomography, CT, A case is presented of a child with signs of when used to evaluate velopharyngeal closure recurrent acute thyroid which was was examined in five normals and five cleft found to result from rupture of an infected palates, during both at rest and during pho- branchial cleft cyst abscess. This association nation of /a/ or /i/. Scanning time was 4.5 has not previously been reported. A review of seconds to obtain CT during phonation. It the bacterial etiologies of suppurative thyroid- was revealed that velopharyngeal motion in itis in childhood is also presented. (Glaser) elevation of the soft palate, inward movement of the lateral pharyngeal walls, and protrusion Moskow, BERNARD S., Bilateral congenital of the retropharynx, was clearly visualized on nasopalatine communication, /. Oral a single roentgenogram. Through the use of Surg., Oral Med., Oral Pathol., Vol. 53, No. this rather simple technique of CT, the au- 5: pages 458-460, May 1982. thors said, rational choice of treatment for Bilateral congenital nasopalatine commu- cleft palates with velopharyngeal insuffi- nication in adults is a rare condition. An ciency seemed possible. (Machida) example-with clinical symptoms is de- scribed. Included is a discussion of the embry- Murayama, N., Takizawa, K., WATANABE, ogenesis and morphology of the incisive canals T., UrEpa, N., OnasHI1, Y., and WAKuUL, and nasopalatine ducts. (Beder) Y., Studies of treatment for cleft lip and/ or palate III Cilinico-statistical analysis of Mmura, T., Onrpa, N., TANAKA, T., and cleft palate patients with speech aid, /. SHnmHaARA, T., Incisive flap (island flap Jap. Cleft Palate Assoc., 6: 85-95, 1981. 292 Cleft Palate Journal, October 1982, Vol. 19 No. 4

During past 7 years, 132 cleft palate with Preanesthetic evaluation was analyzed on or without cleft lip cases were treated by the total of 1135 cleft lip and cleft palate speech aid to improve velopharyngeal incom- operations on 890 children of younger than petence, and were analyzed as follows. 125 six years old, from 1976 to 1980. It was com- had had cleft palate operation before speech pared with that of the controlled 50 children aid treatment, but rest 7 had none as being without the cleft. The body weight and height submucous cleft palate. The age at which of the cleft children were almost within the they began to wear speech aid ranged from 2 normal ranges. The values of the blood ex- years 8 months to 53 years 4 months, 60% of aminations of the both groups were not far them being between 2 and 6 years. Primary beyond the normal ranges. The values of palatoplasty was undergone under one year GOT, GPT, LDH, and AI-P in the serum old in 51 cases, and from one to two years in were slightly higher than the normals, but no 74 cases. 22 cases had more than two opera- clinical evidence of the hepatic disturbance tions. Concerning the speech therapy after was found. Associated birth defects were seen wearing the speech aid, 7 needed none as in 7.1% of the cleft children, such as micro- acquired good speech. Fourteen cases who gnathia in 3.8% and congenital heart disease began to wear speech aid from 2 years 8 in 1.5%. From these physical conditions, it months to 11 years old, acquired good speech might be said that the anesthetic and/or sur- and removed speech aid after average wearing gical risk was not so poor. It was stressed, duration of 2 years 3 months, ranging from 8 however, that the anesthesia should be care- months to 5 years. Seven cases received fur- fully performed to the children with cleft lip ther operation, such as re-push back, velopha- and/or palate, as they often have complica- ryngeal sphincteroplasty and folded pharyn- tions of other anomalies or upper respiratory geal flap plasty. (Machida) inflammation which might be difficult to be evaluated. (Machida) Nopa, E., and Sato, M., Changes in the pressures of the upper and lower lips Onvyama, K., MotonasnHt, N., and Kuropa, during mastication following an experi- T'., Abnormalities of the teeth adjacent mental resection of the upper lip, J. Jap. to a cleft and their orthodontic manage- Cleft Palate Assoc., 6(2): 30-39, 1981. ment, ]. Jap. Cleft Palate Assoc., 6(2): Chronological changes of the lip pressure 40-49, 1981. during masticating banana were studied in 7 This study was undertaken to know the adult monkeys. Just after the experimental incidence of anomaly of the upper anterior labioplasty of the upper lip, the lip pressure teeth in position, number and inclination, in measured by electronic devices much in- cleft lip (and alveolus) with or without cleft creased, but decreased gradually thereafter palate cases, and to discuss the treatment of and approximated to the pre-operative level these teeth. Studied were 145 cases, including on the 30th post-operative day. The lower lip 19 unilateral cleft lip, 4 bilateral cleft lip, 98 pressure, on the other hand, decreased slightly unilateral cleft lip and palate, and 24 bilateral after the operation, but came to the pre-op- cleft lip and palate. They were in Hellman's erative level on the 15th day. These were in dental stages of III A to IV A. The central similar trend to that at rest in which, as incisor frequently had dental axis anormaly, reported before, it was lower than that in such as tip inclination toward lingual or to mastication. Cleft lip surgery may have some the cleft and rotation, leaving in normal only growth-restricting effect on the maxilla and 2.1% of the unilateral cleft lip and palate. The dental arch in the early post-operative pe- lateral incisor did high incidences of missing, riods. (Machida) hypoplasty or inclination to the cleft, being normal in 27.8% of the unilateral cleft lip. O1, K., Kasmima, H., Smmapa, M., UrEm- The canine did the dental axis inclination ATsuv, H., SUZUKI, N., and KuBota, Y., toward the cleft and rotation, but more were Preanesthetic evaluation on the children in normal than the incisors. These abnormal with cleft lip and palate, J. Jap. Cleft teeth were treated as no treatment in 4, ex- Palate Assoc, 6: 58-69, 1981. traction in 4, and orthodontic treatment in ABSTRACTS 293

the rest 137 giving rigid support for the pros- and Human Service, March 1982, pp. 5, thetics. They stated the importance of the 125-134. whole oral habilitation in the cleft patients. Using standard teratologic assays testing (Machida) was completed on 6 chemicals and was in progress for nine other chemicals in FY 1981. O'Ryan, F., and B. N., Deliberate In FY 1982 studies on 10-12 additional chem- surgical control of mandibular growth. J. icals will be started. For use in a collaborative Oral Surg., Oral Med., Oral Pathol., Vol. 53, behavioral study, a standard protocol was No. 1; pages 2-17, January 1982. developed. In FY 1982 evaluation will begin Discussed are the principles governing in six laboratories to assess the sensitivity of mandibular growth. These were applied in an behavioral tests to the behavioral teratogens, evaluation of growth changes in 15 patients d-amphetamine sulphate and methyl mer- with ideopathic mandibular retrognathism curic chloride. In FY 1982 emphasis will be after mandibular advancement surgery. In all placed upon the development of short-term cases, postsurgical growth continued in a prescreens in reproductive system toxicology downward and backward direction. This and teratology. Included in these studies are growth pattern differs from that in patients both in vitro and in vivo teratologic test sys- with a low or median mandibular plane angle tems and a continuous breeding assay for type of facial morphology. Because surgery fertility assessment. Although there is no ref- changed the functional biomechanical vector erence to congenital craniofacial anomalies of force in the condylar-ascending ramus com- per se, knowledge of this ongoing research plex, it is postulated that this affected the should be of interest to those doing research subsequent pattern of mandibular relocation. in this area. (Gregg) The authors present a hypothesis for the specific manner in which alteration of the Sato, K., Ima1, Y., Isuryama, N., KosavyasH1, basic biomechanics of mandibular function M., and Kanazawa, H., Median cleft of surgically can affect subsequent mandibular the lower lip and mandible: report of a growth direction. (Bedet) case, J. Jap. Cleft Palate Assoc., 6: 70-76, 1981. PratER, R. J., and Brack, J. W., The rela- A girl with a median cleft of the lower lip tionship between intraoral palatal meas- and the mandible was seen, and was per- urements and articulation improvement formed reconstruction of the lower lip cleft with training, Brit. J. Dis. Commun., 16: with a z-plasty and plasty of the ankyloglossia 111-118, 1981. at four months of age. Surgical intervention of the mandibular cleft, however, would be A group of 61 children who had /v/ pro- postponed until her second decade of age. No duction problems were given three hours of particular matters were found in her family articulation therapy for their defective sound. history. (Machida) Progress was evaluated using a 60 item word test that was administered before and after therapy. In addition, measurements of palate SHPRINTZEN, R. J., GorpsErc, Rosaum B., length, width, and height were obtained for SarEncER, P., and Spot:, E. J., Male to the subjects and compared with a group of 41 male transmission of Robinow's Syn- normal speaking school children. The authors drome, Am. J. Dis. Child., 136: 594-597, suggest that a child who misarticulates /v/ 1982. and possesses a high palatal arch may have The authors studied a case of male-to-male more difficulty correcting his problem than a transmission in a father and son with Robi- child with a low palatal arch. (Ruscello) now's syndrome and cleft lip-cleft palate, con- firming autosomal dominant inheritance in at Reproductive and Developmental Toxicol- least some cases. Robinow's syndrome is a ogy. National Toxicology Program, Fis- rare congenital malformation syndrome cal Year 1982 Annual Plan, Public which includes macrocephaly, orbital hyper- Health Service, Department of Health telorism, long palpebral fissures, a short nose 294 Cleft Palate Journal, October 1982, Vol. 19 No. 4

with depressed nasal bridge, mesomelic bra- in 78-88% of ears. In some ears the tympan- chymelia, and genital hypoplasia. Occasional ogram type deteriorated again. In 0.5% of malformations have included cleft lip and ears, severe tympanic membrane changes palate, vertebral anomalies, cryptorchism, were present. The authors suggested that sur- and inguinal and umbilical hernia. (Glaser) gical treatment of secretory otitis media be postponed for 3-6 months if no serious STtacno, S., Pass, R. F., THomas, J. P., Navia, changes are present in the ears. No patients J. M., and M. E., Defects of with craniofacial anomalies were reported to tooth structure in congenital cytomega- have been in this series. The senior author lovirus infection, Pediatr., 69: 646-648, reported a similar study, with similar results, 1982. performed upon 2-year old children. (Arch. In most populations congenital cytomega- Otol., 106:345-349, 1980). Because serous oti- lovirus occur with a frequency of tis media is a frequent accompaniment of 0.5% to 2% of live births. In the newborn palatal clefting, the results reported here period this infection is largely clinically in- should provide thought for investigation in apparent; only 5% to 10% of infected infants patients who have craniofacial anomalies. manifest illness. In this small group of symp- (Gregg) tomatic babies, both the type and severity of abnormalities have a wide spectrum. The Turkar, I., Braun, P., and Krupp, P., Sur- _ most frequent manifestations are microceph- veillance of bromocriptine in pregnancy, aly, hepatosplenomegaly, petechia, jaundice, J. Am. Med. Assoc., 247: 1589-1591, 1982. and growth retardation. This paper describes A study of 1410 pregnancies in 1355 women a specific anomaly of tooth structure that who had taken bromocriptine mesylate (for affects mainly primary dentition. Tooth de- amenorrhea, galactorrhea, or luteal insuffi- fects occurred in 40% of those children with ciency-82%; pituitary tumors including ac- the more severe form of infection and in 5.4% romegaly-18%) showed 197 early termina- of those born with asymptomatic infections. tions (14%) and 1213 births (86%). Sponta- This defect was in amelogenesis and may be neous abortions (11.1%), extrauterine preg- considered as a new contributory factor to the nancies (0.9%), and minor (2.5%) and major etiology of dental defects. The group observed (1.0%) fetal malformations were comparable at present is too young for clinical determi- with the frequency in normal populations. nation as to whether or not enamel defects One cleft palate (0.8/1000), one hydrocephaly will occur in permanent teeth. (Glaser) (0.8/1000), one microcephaly (0.8/1000), two Down's syndrome (1.61/1000), and one Pierre Tos, M., Horm-JEnsEn, S., SorEensEn, C. H., Robin syndrome (0.8/1000) constituted the and Mocrnses, C., Spontaneous course craniofacial anomalies. The authors feel that and frequency of secretory otitis media intake of bromocriptine during pregnancy is in 4-year-old children, Arch. Otolaryng., not associated with an increased risk to the 108: 4-10, 1982. ' fetus, but they recommend that the drug be During one year, five tympanometric stopped as soon as pregnancy is confirmed screenings were performed upon 288 random- unless there is a definite indication for its ized, otherwise healthy 4-year old children. continuance. (Gregg) Tympanogram type changed between trials in 50% of ears. Of the 576 ears, 32% had type Warren, D. W., Aut, D. J., and Davip, J., B tympanogram at least once and 73% had Oral port constriction and pressure-air- either type B or Cs, indicating middle ear flow relationships during sibilant pro- pressure -200 mm HO or lower. Type B was ductions, Folia Phoniatria, 33: 380-394, found at three trials during at least six months 1981. in 8% and 24% had either type B or Cz. Estimates of oral port size were made for Although the total frequency of secretory oti- two groups of subjects while they produced tis media was high, spontaneous improvement various syllables containing either the /s/ or was also high and type B changes improved /z/ phonemes. One of the groups exhibited ABSTRACTS 295 normal dental occlusion while the other had tongue-palate contact, were found from pro- subjects with varying degrees of anterior open duction of the consonant to the vowel in bite malocclusion. There was a significant syllables containing /i/, from production of association between oral port size and airflow the consonant to the transition in syllables rate for both groups. Oral pressure and port with /j/, and during production of the con- size showed a similar relationship although sonant in syllables beginning by /s, t, or z/. pressures appeared to decrease above a value By the phonemic analysis, the dental, alveolar of 0.12 cm*. The authors speculate that air and palato-alveolar sounds were substituted pressure or some index related to air pressure by sounds articulated more backwards than is monitored during fricative sound produc- the intended ones. They concluded that the tion. (Ruscello) lateral articulation of Japanese CV sounds were produced mainly as the disorders of the YamasHima, Y., SUZUKI, N., MicH1, K., and broad contact of the tongue and hard palate UEno, T., Lateral articulation in cleft during pronunciation of /i, e, j, s, t, z/. (Mach- palate patients after the primary repair ida) of the palate: observation of the tongue movement by use of dynamic palatogra- phy, J. Jap. Cleft Palate Assoc., 6(2): 8-29, Yosnimura, Y., TaxExisa, K., and Fujino, T., 1981. Comparison of the one-year-postopera- tive result of our two methods of palato- To reveal the lateral articulation, analyzed plasty, J. Jap. Cleft Palate Assoc., 6: 77-84, were 260 sounds diagnosed as the lateral ar- 1981. ticulation and 33 suspected as it pronounced by seven cleft palate patients, 5-year-11- Two types of palatoplasty were used. In the month to 12-year-11-month old, with opera- type 1, hinged flaps were elevated from mu- tion at 1-year-1-month to 2-year-4-month of coperiosteum along the cleft margin of the age, and sufficient velopharyngeal functions. hard palate, and a full-thickness z-plasty was The sounds were studied by the confusion performed at the posterior third of the soft matrix paradigm for phonemic feature, and palate. In the type 2, standard push-back the tongue movements by the dynamic pala- procedure was done on the palatal side, and tography and cephalometric radiography the nasal raw surface was covered by two with contrast medium on the tongue and myomucosal flaps elevated along the margin palate. Some of the results were as follows. of the soft palate cleft. One year after the The lateral articulation were observed in the operation, the results were compared in eight Japanese CVs containing /i, j, s, ts, dz/ and cases of each operation method. The type 1 /ke, ge/. The tongue contacted to the hard procedure was much better than the other in palate continuously during pronunciation. velopharyngeal function, speech performance The closure of the articulation points, or the and fistula formation. (Machida)

ANNOUNCEMENTS

ACPA 40TH ANNUAL MEETING MAY 4-7, 1983

HYATT REGENCY-INDIANAPOLIS, INDIANA

The 40th annual meeting of the American Cleft Palate Association will be held May 4-7, 1983, at the Hyatt Regency in Indianapolis, Indiana. Deadline for submission of abstracts is October 15, 1982. Program highlights will include a guest lecture on medicolegal aspects of birth defects by Dr. Robert Brent, editor of Teratology; a tutorial session on microbeam radiography by Dr. James Abbs of the University of Wisconsin; an information exchange forum for clinical investigators utilizing computerized storage and retrieval of patient infor- mation; a session on pharyngeal flap revision; and a tentative schedule of entry-level short courses for students and new professionals.

FIFTH ANNUAL WORKSHOP ON SURGICAL TECHNIQUES in Cleft Lip and Palate November 30-December 4, 1982 at the Grand Hyatt Hotel, New York, New York under the sponsorship of Manhattan Eye, Ear and Throat Hospital and the Institute of Reconstructive Plastic Surgery at New York University Medical Center. Director: V. Michael Hogan, M.D., New York, N.Y. Co-Directors: Kenneth E. Salyer, M.D., Dallas, Texas Janusz Bardach, M.D., Iowa City, Iowa Guest Co-Director: Fernando Ortiz-Monasterio, M.D., Mexico City, Mexico This workshop emphasizes current surgical techniques in the repair of cleft lip and palate, cleft lip nasal deformities, surgery for velopharyngeal incompetence, and the treatment of maxillofacial defects associated with cleft lip and palate. The fundamentals of cleft lip and palate embryology, anatomy, and genetics will also be discussed.

AMA-CME Credits, Category 1: Fee $600, Residents $300: Enrollment limited. For further information contact: Nancy Abbate, R.N., c/o V. Michael Hogan, M.D., 799 Park Avenue, New York, New York 10021, (212) 737-8300

FIRST ANNUAL HAWAII-PACIFIC CLEFT SYMPOSIUM will be held on February 13-17, 1983, at the Prince Kuhio Hotel, Waikiki, Honolulu, Hawaii. Co-sponsored by the American Cleft Palate Educational Foundation, the Hawaii Speech-Language-Hearing Association, and The Honolulu Medical Group Research and Education Foundation. This will be a major international congress of multidisciplinary specialists dealing with diagnostic and treatment approached for the cleft, craniofacial and neurogenic patient. Fee is $300 for M.D.'s and D.D.S.'s; $100 for all others. 24 CME, DDS, and CEARP credits. For more information please contact: Yvonne Brewer, (808) 537-2211 or write to HPCS, Research and Education Foun- dation, 550 So. Beretania Street, Honolulu, Hawaii 96813.

BOYS TOWN SYMPOSIUM The Boys Town Institute for Communication Disorders in Children is planning a one-day symposium for the Spring of 1983 on the topic "Velopharyngeal Management for Individuals with Dysarthria". We wish to examine the effectiveness of various 296 . ANNOUNCEMENTS 297 treatments for neurogenic, velopharyngeal incompetence including surgical prosthetic, and behavioral procedures. We would like to identify via a questlonnalre the persons with experlence for a full coverage of the topic. If you or someone you know are interested in presenting; attending, or both, please write to: Ronald Netsell, Boys Town Institute, 555 N. 30th St., Omaha, NE 68131.

THE CRANIOFACIAL SOCIETY OF GREAT BRITAIN-INTERNATIONAL MEETING. An International Meeting on Cleft Lip and Palate will be held in Birmingham, England from 13-16 July, 1983. An international faculty of invited speakers will address all aspects of habilitation with emphasis on long term results and future prospects. Submissions for addi- tional papers are requested before 31 January, 1983. Registration limited to 200. For further information contact Mr. A. G. Huddart, Dental Department, Corbett Hospital, Stourbridge, West Midlands DY8 4JB England.

FELLOWSHIP FOR NURSES Funds are available to assist nurses who wish to attend the 1983 Annual Meeting of the American Cleft Palate Association in Indianapolis, May 4 through 7. The competitive grants are awarded from the Donna Pruzanksy Memorial fund of the American Cleft Palate Educational Foundation. Nurses who are involved in the care of patients with craniofacial anomalies and who wish to increase their knowledge of the field are suitable applicants. Applications must be received by November 15, 1982. Recipients will be announced no later than February 15, 1983. Applications may be obtained from: Jane Angelone Graminski, Administrative Secretary, ACPEF National Office, 331 Salk Hall, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, Telephone: 412-681-9620. INDEX TO VOLUME 19, 1982 CLEFT PALATE JOURNAL

AUTHORS

Atkins, R. W., 267 Lehnert, M. W., 9 Berkowitz, S., 129 Lejour, M., 113 Bull, H. G., 167 Long, N. V., 57 Byrd, H. S., 267 Long, R. E. Jr., 62 Bzoch, K. R., 47 Maeker, R., 167 Cantekin, E. I., 17 Marsh, J. L., 212 Cohen, M. M., 89 McWilliams, B. J., 281 Cutting, C. B., 25 Messer, L. B., 9 Dahl, E., 258 Moffett, B. C., 89 Dalston, R. M., 1, 57 Munro, R. R., 72 De Mey, A., 113 Nghiem-Phu, L., 129 Doyle, W. J., 17, 119 Oka, S. W., 206 Eisenbach, C. R., 47 Peat, J. H., 100 Eldeeb, M., 9 Pruzansky, S., 139 Eliason, M., 249 Ramig, L. A., 270 Figueroa, A., 139 Richman, L. C., 249 Finnigan, D. E., 222 Rood, S. R., 119 Fogh-Andersen, P., 258 Ross, R. B., 1, 145 Folkins, J. W., 25 Ruscello, D. M., 181 Furlow, L. T., 47 Rygh, P., 104 Gado, M., 212 Saad, M. M., 17 Genba, R., 275 Saito, K., 231 Guillermo, G., 129 Schmitz, R., 167 Gundlach, K. K. H., 167 Schubert, J., 83 Hebda, T. W., 9 Shprintzen, R. J., 194 Iregbulem, L. M., 201 Siegel-Sadewitz, V., 194 Jain, R. B., 62, 206 Smith, B. E., 172 Jensen, B. L., 258 Tebbetts, J. B., 267 Johnston, M. C., 230 Tindlund, R., 104 Kohama, G., 275 Waite, D. E., 9 Kokich, V. G., 89 Warren, D. W., 286 Komatsu, Y., 275 Weinberg, B., 172 Kreiborg, S., 258 Williams, W. N., 47 Krogman, W. M., 62, 206 Zwitman, D. H., 36, 40 Kuehn, D. P., 25

298 INDEX TO ARTICLES

TITLES BY SUBJECT

Achievement CAT Scan Cleft Lip and Palate, Richman, 249 Marsh, 212 American Cleft Palate Association Cephalometric Studies Warren, 286 Cleft Lip and Palate, Dahl, 258; Krogman, 62, 206; Animal Research Peat, 100 Doyle, 17; Schubert, 83 Cinefluorography Asplenia Syndrome with Cleft Lip Furlow, 47 Saito, 231 Communication Cleft Lip and Palate Infants, Long, 57 BOOK REVIEWS INDEX Volume 19 Advances in the Management of Cleft Palate; Edwards, Craniofacial Anomalies M. and Watson, A. C. H., Eds., 74 Asplenia Syndrome with Cleft Lip, Saito, 231 Anatomy and Physiology of Speech: Laboratory Text- Cloverleaf Skull, Kokich, 89 book; Kaplan, Harold M., 150 Craniofacial Dysostoses, Marsh, 212 Central Nervous System and Craniofacial Malforma- Diagnosis, Marsh, 212 tions. Vol. 7 in Advances in the Study of Birth Defects; In Nigeria, Iregbulem, 201 Persaud, T. V. N., 233 Prevention, Johnston, 230; Schubert, 83 Dentistry in the Interdisciplinary Treatment of Genetic Terminal Transverse Defects, Figueroa, 139 Diseases March of Dimes Birth Defects: Original Ar- Craniofacial Growth ticle Series; Vol. XVI, No. 5; Salinas, Carlos F. and (see Growth, Facial) Jorgenson, Ronald J., Eds., 152 Diagnosis and Treatment of Palato-Glossal Malfunction; Craniofacial Surgery Ellis, R. E. and Flack, F. C., Eds., 151 Marsh, 212; Munro, 72 Diagnostic Approaches to the Malformed Fetus, Abortus, Electromyography Stillborn and Deceased Newborn; Globus, Mitchell S. Kuehn, 25 and Hall, Bryan D., Eds., 76 Diagnostic Handbook of Speech Pathology; Hutchinson, Endoscopy Barbara B., Hanson, Marvin L. and Mecham, Merlin Rood, 119; Siegel-Sadewitz, 194; Zwitman, 36, 40 L., Eds., 77 Epidemiology Etiology of Cleft Lip and Cleft Palate; Melnick, Michael, Cleft Lip and Palate in Nigeria, Bixler, David and Shields, Edward D., Eds., 232 Iregbulem, 201 Hearing Loss in Children; Jaffe, B., Ed., 152 Eustachian Tube Long Term Treatment in Cleft Lip and Palate (With Rood, 119 Coordinated Team Approach); Kehrer, B., Slongo, T., Graf, B. and Bettex, M., Eds., 74 Facial Growth The Management of Genetic Disorders Vol. 34, Progress (see Growth, Facial) in Clinical and Biological Research; Papadatos, Con- Funding stantine J. and Bartsocas, Christos S., Eds., 76 Cleft Lip and Palate Treatment, Warren, 286 Plastic and Reconstructive Surgery of the Face-Cos- metic Surgery; Pirruccello, F. W., 153 Growth, Facial Progress in Clinical and Biological Research, Vol. 44: Cleft Lip and Palate Perinatal Medicine Today; Young, Bruce K., Ed., 75 Cost Measurement, Berkowitz, 129 Rapid Maxillary Expansion; Timms, Donald J., 232 Cephalometric Studies, Dahl, 258; Krogman, 62, 206; Reproductive Pasts, Reproductive Futures: Genetic Peat, 100 Counselling and Its Effectiveness; Sorenson, James R., Intelligence Swazey, Judith P. and Scotch, Norman A., 234 Cleft Lip and Palate, Richman, 249 Teaching Linguistically Handicapped Children; Berry, Mildred F., 150 Middle Ear Doyle, 17 Behavior Obturators Cleft lip and palate, Richman, 249 Ruscello, 181 Biofeedback Occlusion Dalston, 1; Ruscello, 181; Siegel-Sadewitz, 194 Peat, 100 Bone Grafts Optical Profilometer Cleft Alveolus, El Deeb, 9 Berkowitz, 129 299 300 Cleft Palate Journal, October 1982, Vol. 19 No. 4

Orthodontics Speech Rating Cleft Lip and Palate, Peat, 100; Rygh, 104 Cleft Lip and Palate Ramig, 270 Pharyngeal Flap Furlow, 47; Zwitman, 36, 40 Speech Therapy McWilliams, 281 (see also Velopharyngeal Insufficiency) Pressure Flow Dalston, 1; Smith, 172 Surgery Cleft Lip Repair and Evaluation, Gundlach, 167; Lejour, 113 Prevention Cleft Palate, Atkins, 267 Craniofacial Anomalies, Cleft Lip and Palate, Johnston, 230; Columella, Lejour, 113 Schubert, 83 Teachers Information & Experience Psychosocial Cleft Lip and Palate Cleft Lip and Palate, Finnegan, 222 Achievement, Richman, 249 Teflon Injection Behavior, Richman, 249 Furlow, 47 Characteristics, Richman, 249 Velopharyngeal Function Intelligence, Richman, 249 Atkins, 267; Kuehn, 25; Siegel-Sadewitz, 194; Smith, Teachers Information & Experience, Finnegan, 222 172; Zwitman, 40 Radiographs Velopharyngeal Insufficiency Dahl, 258; Krogman, 62, 206; Kuehn, 25; Marsh, 212; Diagnosis, Dalston, 1; Zwitman, 40; Komatsu, 275 Peat, 100 Treatment, McWilliams, 281; Ruscello, 181; Zwitman, 36, 40 Sex Differences Biofeedback, Dahiston, 1; Ruscello, 181 Cleft Lip and Palate, Krogman, 62 Obturators, Ruscello, 181 Specimens, Human Pharyngeal flap, Furlow, 47; Zwitman, 36, 40 Kokich, 89 Teflon, Furlow, 47 Speech Pathology X-Rays McWilliams, 281 (see Radiographs) 5 STOCK CLEARANCE SALE-

CLEFT PALATE JOURNAL FOR A LIMITED TIME ONLY (until Dec. 31, 1982)

i We are offering fantastic bargains on valuable old

* journals. b

$ # *4>

f -- INVEST IN ANTIQUES b» AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA/A Ke M § ANY ISSUE * from Vol. 1, No. 1 (Jan. 1964) to Vol. 10 (Oct. 1973) ¥ § - for the price of handling and mailing-$2.00 y # Ke X ANY ISSUE from Vol. 11 (Jan. 1974) to Vol. 6 (Oct. 1979) w

for half price-$4.50 Y

& 6.

$ y g W ~'t

M *

LIBRARY i3 INSTANT * f

ALMOST COMPLETE* SETS of Volumes 1 to 10, ""n"

f regularly $324 nr

for only $75.00 r

f a

COMPLETE SETS of Volumes 11 to 16, regularly $216 for § a

a

only $100 a

a f Aa

Aa a A

as A

£ HURRY-SUPPLIES ARE LIMITED! A

6."

3 A AL $ Do your Christmas shopping now!

Ke ARRL f * We are missing copies of the following six journals: Vol. 3: nos. 1, 2 and 3 (1966); & Vol. 4: no. 1 (1967); Vol. 5: no. 1 (1968); Vol. 6: no. 1(1969) K If you have one of these issues, please donate it. 4 AMERICAN CLEFT PALATE ASSOCIATION ¢ 331 Salk Hall, University of Pittsburgh Pittsburgh, Pennsylvania 15261 Telephone: 412-681-9620