Wilma Maue-Dickson, Ph.D. 261 Section I. Epidemiology, Etiology, and Pathogenesis of Cleft Lip and Palate Alphonse R

OCTOBER 1977 VOLUME 14, NUMBER 4

TABLE OF CONTENTS

CrErT Lip aAnp ParaTE ReEsEaRcH: An UPDATED STATE oF THE ART Samuel G. Fletcher, Ph.D., (Chairman), Samuel Berkowitz, D.D.S., M.S., Doris P. Bradley, Ph.D., Alphonse R. Burdi, Ph.D., Leonard Loch, M.D. and _ Wilma Maue-Dickson, Ph.D. 261 Section I. Epidemiology, Etiology, and Pathogenesis of Cleft Lip and Palate Alphonse R. Burdi, Ph.D., Chairman .... 262 Section II. Anatomy and Physmlogy Wilma Maue-Dickson, Ph.D., Chairman =...... vv... 270 Section III. Orofacial Growth and Dentistry Samuel Berkowitz, D.D.S., M.S., Chairman, Samir E. Bishara, D.D.S., Leonard S. Fishman, D.D.8., Hans Friede, D.D.S., Albert H. Guay, D.M .D., Rune Hellquist, Odont. D., Charles R. Kremenak, D.D.S., W. E. LaVelle, D.D.S., Joan Morris, M.A., H. Pashayan, M.D., Mohammed Mazaheri, D.D.S., Jeffrey Rubenstein, D.M.D., and Birgit L. Thilander, D.D.S...... 288 Section IV. Surgical Aspects and Management Leonard Koch, M.D., Chairman, David G. Bowers, M.D., Leonard Furlow, j?” M.D., Joseph D. Kapes M.D. and James V . Scarcella, M D...... e.}. 302 Section V. Resonance and Phonation Samuel G. Fletcher, Ph.D., Chairman ...... e.... 313 Section VI. Speech and Language Aspects Doris P. Bradley, Ph.D., Chairman ...... v...... 321 A PLEA FOR AN INTERDISCIPLINARY APPROACH TO THE RADIOLOGICAL STUDY OF THE VELOPHARYNGEAL PORTAL-A GUEST EDITORIAL M. Leon Skolinick, M.D. 329 LETTER TO THE EDITOR ..... lk aa e e e e e n n n n e e e e n e e e e e e a a a e ave e e e a a a eas 331 BOOK REVIEW ...l yv a s e a a e a b e n n n n n n a n n a e e e e e e e e a e e a e e a e e a e eae es 332 ABSTRACTS ...... sa ke a k k n b e n e e nn n n n a e e a e e e e a e e a e e e e e a e e a e e a e e a e e a e eae. 333 ANNOUNCEMENTS |...... a ak k a k e e a a e e ba e e e e e e e a e e e a e e e a e e ae e e e ae a e e a ae es 338

AUTHORS INDEX TO ABSTRACTS OF THE THIRD INTERNATIONAL CONGRESS ON GCLEFT PALATE \.... 4k k a a n e e e e e e e e e n n n n n n a n a aaa a a aan ne e e e e e e e e e e e e e e e e e e e aa aas 3586 ABstTRACTs or PareErs, Tramninc SEssions, Ficms, PosTERS AND SCIENTIFIC ExHIBITs or THE THIRD INTERNATIONAL CONGRESS oN GCLEFT ParaTr, ToroNnToO, ONTARIO, CANADA, JUNE 5-10, 1977 \...... lulu va a aa a ae e a e ee e eee e . c.. 341 InpEx To 14, 1977, CLEFT PALATE JOURNAL 389

AMERICAN CLEFT PALATE ASSOCIATION

1977-1978 OFFICERS President ..a kk kkk} John Q. Owsley, M.D., San Francisco, California President Elect .R. Bruce Ross, D.D.S., M.Sc., Toronto, Ontario, Canada Past President ...... Kenneth R. Bzoch, Ph.D., Gainesville, Florida Vice President ...... William S. Brandhorst, D.D.S., M.S., St. Louis, Missouri Vice President Elect ...... William S. Garrett, M.D., Pittsburgh, Pennsylvania SQCretary .k .la ak ka kak ka k a k k eas David R. Dickson, Ph.D., Miami, Florida Treasurer ...l kaka lls Sylvan E. Stool, M.D., Pittsburgh, Pennsylvania ECItOF =...... lls k k ees Betty Jane McWilliams, Ph.D., Pittsburgh, Pennsylvania Historian and Editor of Newsletter ...... Charlotte G. Wells, Ph.D., Columbia, Missouri

COUNCIL MEMBERS The above officers and Alphonse R. Burdi, Ph.D. (1978) =. lv kk e ee e e e e e e es Ann Arbor, Michigan J. Douglas Noll, Ph.D. (1978) =... .ll lv lk a e k ek e ek ee e e eee Lafayette, Indiana Leslie H. Holve, M.D. (1979) ...... lll k e e e es Santa Monica, California Richard P. Jobe, M.D. (1979) .. .ll e ee e e e ee k eke Los Altos, California George J. Chierici, D.D.S. (1980) _. .re es San Francisco, California Sally J. Peterson-Falzone, Ph.D. (1980) =...... e e es Chicago, Illinois Morton S. Rosen, D.D.S., Ex OffICIO .ll vv ae k e r a e ee kak ees Chicago, Illinois Donna R. Fox, Ph.D., Ex OffICIO lla vk k av k e e e ee ka e k ees Houston, Texas

ADMINISTRATIVE SECRETARY Mrs. Flora P. Berk 331 Salk Hall University of Pittsburgh Pittsburgh, Pennsylvania 15261 Telephone: 412-681-9620 GENERAL INFORMATION The Cleft Palate Journal is a quarterly publication of the American Cleft Palate Association. It appears in January, April, July, and October and: is printed by Waverly Press, Inc., Mt. Royal and Guilford Avenues, Baltimore, Maryland 21202. Second Class postage is paid at Pittsburgh, Pennsylvania, and at additional mailing offices. Manuscripts and related correspondence should be addressed to Betty Jane McWilliams, Ph.D., Edi- tor Cleft Palate Journal, Cleft Palate Center, University of Pittsburgh, Pittsburgh, Pennsylvania 15261. More detailed "Information to Contributors" will be found inside the back cover. Subscription rates, effective January, 1977, are $35.00 per calendar year both in the United States and abroad. Single copies are available at $9.00 per issue. Subscriptions, orders for back copies, and business correspondence should be addressed to Mrs. Flora P. Beck, Administrative Secretary, American Cleft Palate Association, 331 Salk Hall, University of Pittsburgh, Pittsburgh, Pennsylvania 15261. Address changes should be sent to the Administrative Secretary at least one month prior to the change. Subscribers and ACPA members must notify the Post Office that they will guarantee postage for the forwarding of undelivered copies. Other claims for undelivered copies must be filed within one month of the expiration of the subscription year.

CLEFT

PALATE Journal

EDITOR BETTY JANE McWILLIAMS, Ph.D. Cleft Palate Center University of Pittsburgh Pittsburgh, Pennsylvania 15261 EDITORIAL ASSISTANTS PRESTON A. WILSON HELEN BAUM STATISTICAL FLOYD H. TAYLOR, Sc.D. Pittsburgh, Pennsylvania CONSULTANT

SECTION EDITORS Anatomy and Embryology ALPHONSE R. BURDI, Ph.D., Ann Arbor, Michigan Basic Science DAVID R. DICKSON, Ph.D., Miami, Florida Clinical Genetics and HERMINE PASHAYAN, M.D., Boston, Massachusetts Pediatrics Dentistry HOWARD ADUSS, D.D.S, Chicago, Illinois Otolaryngology CECIL W. HART, M.D., Chicago, Illinois Plastic Surgery WILLIAM C. TRIER, M.D., Tucson, Arizona Radiology M. LEON SKOLNICK, M.D., Pittsburgh, Pennsylvania Speech and Behavioral DUANE R. VAN DEMARK, Ph.D., lowa City, lowa Sciences Teratology JOSEF WARKANY, M.D., Cincinnati, Ohio Clinical Conferences SAMUEL PRUZANSKY, D.D.S., Chicago, Illinois Book Reviews JEANETTE K. LAGUAITE, Ph.D., New Orleans, Louisiana Abstracts BARD COSMAN, New York, New York

The Cleft Palate Journal is an international publication designed to reflect research and clinical activities in the many fields concerned with the study and treatment of cleft lip and cleft palate, other craniofacial anomalies, and related problems.

Changes of address and subscription orders may be placed with: American Cleft Palate As- sociation, Mrs. Flora P. Berk, Administrative Secretary, University of Pittsburgh, Pennsylvania 15261.

Manuscripts and correspondence should be submitted to the editor

Copyright © 1977 The American Cleft Palate Association Published quarterly by the American Cleft Palate Association Printed by Waverly Press, Inc., Mt. Royal & Guilford Avenues, Baltimore, Maryland 21202 Subscription rate: $35.00 per volume, $9.00 per issue Second class postage paid at Pittsburgh, Pa. and at additional mailing offices

EDITORIAL

CONSULTANTS

. . . for Volume 14,

January to October, 1977 of the CLEFT PALATE JOURNAL

Jerome E. Adamson, M.D. Charles R. Kremenak, Jr , D.D.S. l. Kenneth Adisman, D.D.S. William R. Laney, D.M.D , M.S. Howard Aduss, D.D.S. Ralph A. Latham, B.D. Ph.D. Gasper W. Anastasi, M.D. James A. Lehman, Jr., M .D. Charles Anderson, Ph.D. Dr. R. B. Lowry Dr. Arthur S. AyIsworth Jack Matthews, Ph.D. William J. Babler Mohammad Mazaheri, D.D.S. Rolf Behrents, D.D.S. Julius D. Metrakas, Ph.D. Milton D. Berkman, D.M.D. Karlind T. Moller, Ph.D. Samuel Berkowitz, D.D.S. Edmond A. Murphy, M.D. David Bixler, D.D.S., Ph.D. Robert M. Oneal, M.D. William S. Brandhorst, D.D.S. John M. Opitz, M.D. Raymond O. Brauer, M.D. Hermine M. Pashayan, M.D. Alphonse R. Burdi, Ph.D. Earlene Tash Paynter, Ph.D. Patrick J. Carney, Ph.D. Sally J. Peterson-Falzone, Ph.D. Mary Ann Carpenter, Ph.D. Robert Pool, M.D. - Jaroslov Cervenka, M.D., Ph.D. Samuel Pruzansky, D.D.S. C. Hal Chaplin, M.D. Peter Randall, M.D. Edward Clifford, Ph.D. Lynn C. Richman, Ph.D. Peter J. Coccaro, D.D.S. Ralph L. Shelton, Jr., Ph.D. Elda Lane Coco Robert J. Shprintzen, Ph.D. Bard D. Cosman, M.D. Gary R. Smiley, D.D.S. James P. Dworkin, Ph.D. David W. Smith, M.D. Dr. Murray Feingold L. M. Solomon, M.D. F. Clarke Fraser, M.D. David B. Stark, M.D. David W. Furnas, M.D. Phillip A. Stone, M.D. William S. Garrett, M.D. Sylvan E. Stool, M.D. Robert J. Gorlin, M.D. Elca T. Swigart, Ph.D. Donald M. Greer, Jr., M.D. Rosemary F. Tharp, M.A. David J. Hall, D.D.S. William C. Trier, M.D. Robert L. Harding, M.D. Gabriel F. Tucker, M.D. Cecil W. Hart, M.D. Duane R. Van Demark, Ph.D. Egil P. Harvold, D.D.S. Donald W. Warren, D.D.S., Ph.D. Hugh N. Hazenfield, M.D. Bernd Weinberg, Ph.D. V. Michael Hogan, M.D. Linton A. Whitaker, M.D. Michael E. Jabaley, M.D. Clyde R. Willis, Ph.D. Malcolm C. Johnston, D.D.S., Ph.D. Libby F. Wilson, M.D. Ronald J. Jorgensen, M.D. Sidney K. Winn, M.D. Celia Kaye, M.D., Ph.D. Robert B. Winslow, M.D. Charles A. Kelsey, Ph.D. Richard B. Yules, M.D. James A. Zagzebski, Ph.D.