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EDITORIAL in Its First 21 Volumes, the Cleft Palate Journal Has EDITORIAL In its first 21 volumes, The Cleft Palate Journal has established a reputation for the publication of multidisciplinary research and clinical information important to the study and treatment of cleft lip and cleft palate, other craniofacial anomalies, and related problems. This issue reflects several changes in the Journa!l-change in Editor, producer, and printer, differentiation between articles and reports, and inclusion of the Craniofacial-Cleft Palate Bibliography. However, in this time of change, the Journal staff will strive to maintain the traditions of the Journal and the quality of work on which its reputation rests. This issue was influenced by the previous Editor, Dr. R. Bruce Ross. He and his editorial associates edited drafts of some of the papers published here. He has also assisted, instructed, and supported me during the transition period. Bruce, thank you. The Journal is now being produced by B.C. Decker, Inc. The contribution of the Decker firm to the Journal includes a final editing for grammar and conformity to Journal style, layout, printing, and distribution. The style for reference list entries has been modified to save space and to conform to current practices. This change is described in the Instructions to Authors. The style of headings and subheadings has also been changed. Thanks to Brian Decker and Agnes Mclvor for their contributions. The distinction between articles and reports is described in a policy statement included in the Instructions for Authors. This statement is intended to reflect the kind of material that the Journal has been publishing. It does not establish new direction but rather makes policy explicit for the benefit of contributors and for possible alteration in the future. The quality of a journal is determined by the quality of the material submitted to it. We thank authors for the contributions we have received, and we encourage future submissions. There is not always agreement among our readers about the value of material accepted for publication. A journal necessarily draws criticism. The Letters to the Editor section provides a channel for constructive criticism and for exchange of informed opinion. Ralph L. Shelton, Jr., Ph.D. 63 ABSTRACTS - BARDACH J, MORRIS H, OLIn W, MCDEER- position. This is an impressive, well illus- moTT-MurrRay J, Moonry M, BArR- trated article. (Lindsay) DACH E. Late results of multidiscipli- Reprints: Division Plastic Surgery nary management of unilateral cleft lip Primary Children's Hospital 324 - 10th Avenue and palate. Ann Plast Surg 1984; Salt Lake City, Utah 84103 12:235-248. The treatment, history, and present sta- Dan BB. Vietnam and birth defects. JAMA tus of 45 patients 14 to 22 years of age was 1984; 252:936-937. - studied to examine the efficacy of the multidisciplinary approach to treatment of This editorial is an adjunct to an article cleft lip and cleft palate used at the Uni- by Erickson et al (JAMA 1984; 252:903- versity of Iowa Hospitals and Clinics. The 912) relating to the possibility that Agent authors found a high incidence of unsat- Orange causes congenital malformations isfactory esthetic and functional results in in the offspring of Vietnam veterans. The the treatment of the lip, nose, and pal- technical background to the situation is ate-approximately 47 percent of pa- evaluated, as well as another study relat- tients. A list of possible causes of failure is ing to the effect of Agent Orange on Aus- included in the article. I was disappointed tralian Vietnam veterans, who demon- that lay evaluators were not used and that strated no evidence that Army service in the article contained no evaluation of the Vietnam increased the risk of fathering overall success or failure of habilitation in children with congenital anomalies. The these patients. (Lindsay) Australians' risk was independent of length Reprints: Dr. J. Bardach of service in Vietnam or the elapsed time University of Iowa Hospitals from the father's return to the conception Dept. Otolaryngology-Head Neck Surgery of a child. The editor emphasized that Er- Iowa City, Iowa 52242 ickson et al were appropriately cautious in interpreting the results, but he went on to BROADBENT TR, WOOLF RM. Cleft lip na- state that "a fairly strong statement can be sal deformity. Ann Plast Surg 1984; made that it is unlikely that serious con- 12(3): 216-234. genital anomalies in children of men serv- ing in Vietnam resulted from that expe- This article from the Division of Plastic rience". A plea was made to expend more Surgery, Primary Children's Hospital, Salt effort in preventing birth defects in any Lake City, states that the nasal deformity child. (Gregg) in the patient with cleft lip is produced be- cause the lower lateral cartilage is sub- luxed inferiorly and laterally. The colu- ERICKSON JD, MULINARE J, MCCLAIN PW, mella is not truly short. The nasal portion FITCH TG, JAMES LM, MCCLEARN AB, of this cleft deformity is corrected at the ADAMS MJ. Vietnam veterans' risks for time of primary lip surgery by advancing fathering babies with birth defects. the lower lateral cartilage superiorly and JAMA 1984; 252:903-912. medially, utilizing an intranasal incision which is traced between the lower and up- The risk that Vietnam veterans might per lateral cartilages and extends well into produce offspring with major structural the nasal tip area. The advanced lower lat- birth defects was assessed by means of in- eral cartilage is fixed to the septum and terviews with mothers and fathers of chil- the upper lateral cartilage in the corrected dren in both case and control groups and 64 ABSTRACTS 65 by reviewing military records. In general, ate were studied. The birth physical ex- Vietnam veterans had no increased risk of amination data were collected from the producing children with defects, and vet- birth records. At their first visits to the au- erans who had greater estimated oppor- thors' clinic, physical statistics were mea- tunity for exposure to Agent Orange did sured and bilateral carpal bone x-ray films not appear to have greater risk of pro- were taken. These were compared with the ducing offspring with all types of defects standard Japanese data for corresponding combined. For some specific defects, among age groups. The results were as follows: them cleft lip without cleft palate, the es- the physical statistics at birth were not sig- timated risks were higher for subgroups nificantly different, but at the first visit of Vietnam veterans who were more likely lower height, lighter weight, and smaller to have been exposed to Agent Orange. It chest girth were noted; ossification of car- was speculated that the higher risk could pal bones was greater but not significant be due to chance, some experience in the in the developmental status; develop- Vietnam service of the father, or some un- mental abnormality based on Fanconi's in- identified factor. (Gregg) dex was most obvious in the bones, and least obvious in body weight; the children with cleft who were between 6 and 12 years HowELL DM, GUMBINER CH, MARTIN of age were small and lean. (Machida) GEO. Congestive heart failure due to Reprints: Dr. N. Kasuya giant cutaneous cavernous heman- Department Oral Surgery glioma. Clin Pediatr 1984; 23:504-506. School of Medicine, Nagoya University 65 Tsurumai, Showa-ku The study presented a female infant with Nagoya City, Aichi 446, Japan isolated giant cutaneous cavernous he- mangioma of the face and secondary se- KERNAHAN DA, DADO DV, BAUER BS. The vere congestive heart failure. Studies to anatomy of the orbicularis oris muscle identify other major arteriovenous mal- in unilateral cleft lip based on a three- formations were negative. Treatment of the dimensional histologic reconstruction. patient with a corticosteroid was not suc- Plast Reconstr Surg 1984; 73:875-881. cessful in reducing the size of the heman- The authors from the Children's Me- glioma. She required an aggressive anti- morial Hospital in Chicago were able to congestive medical regimen for 2 years. examine the mid-face of a full term still- Though not previously described in the- born infant with a right unilateral cleft lip literature, high-output congestive heart and cleft palate by means of serial histo- failure can occur secondary to isolated cu- logic sections and the construction of a taneous hemangioma. Aggressive medical three-dimensional model. The arrange- management may alleviate the need for the ment of the orbicularis oris muscle fibres increased risk of surgical or other thera- differed markedly from previous descrip- peutic approaches in this often self-limited tions. There was a chaotic arrangement of condition. (Glaser) muscle fibres with no separate muscle lay- Reprints: Dr. Carl H. Gumbiner ers distinguishable. There was no evi- 3300 West Dodge Road Suite 416 dence of muscle bundles paralleling the Omaha, NE 68114 cleft margins. Muscle fibres on both sides of the cleft inserted into the dermis, al- though the amount of muscle on the me- Kasuya M, HIrAIwWA K, NIsHI M, Ka- dian side was quite sparse compared with NEDA T, OKA T. Physical measure- the lateral side. The authors feel there is ment and biological age of cleft lip and/ strong justification for further histologic or palate patients. J Jap Cleft Palate investigation of this anomaly. (Lindsay) Assoc 1984; 9:25-34. Reprints: Dr. D. Kernahan Children's Memorial Hospital The physical growth and development Director Plastic Surgery - of 115 children with cleft lip and/or pal- Chicago, Illinois 60614 66 Cleft Palate Journal, January 1985, Vol. 22 No. 1 KoBUS K. Extended vomer flaps in cleft terior cricoarytenoid muscle resulted as palate repair: a preliminary report. follows. It elicited remarkable changes of Plast Reconstr Surg 1984; 73:895-903. the levator responses, facilitation within 10 to 20 msec, and inhibition within 30 to 250 This article is from the Hospital for msec of the testing interval.
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