**Author details**

Norifumi Nakamura\* and Masahiro Tezuka

\*Address all correspondence to: nakamura@dent.kagoshima-u.ac.jp

Department of Oral and Maxillofacial Surgery, Field of Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

## **References**

[1] Stengelhofen J: The nature and causes of communication problems in cleft palate. In: Sengelhofen J, editors. Cleft Palate: The Nature and Remediation of Communication Problems. Edinburg: Churchill Livingstone; 1989:1-30.


**7. Conclusions**

70 Designing Strategies for Cleft Lip and Palate Care

**Author details**

**References**

those of Japanese children without cleft palate.

Norifumi Nakamura\* and Masahiro Tezuka

\*Address all correspondence to: nakamura@dent.kagoshima-u.ac.jp

Problems. Edinburg: Churchill Livingstone; 1989:1-30.

Cleft palate repair using a modified V-Y palatoplasty combining with a large Z-plasty and a mucosal graft on the nasal side of the velum for symmetrical muscular reconstruction based on the surgical strategy that approaches each anatomical and pathological abnormalities of cleft palate. Following palate repair based on our surgical strategy, patients' speech was significantly improved, and the nasalance scores were recovered to almost the same levels as

 **Figure 8.** The midline defect of the velum of endoscopic examination might be a critical cause of VP closure dysfunction.

Department of Oral and Maxillofacial Surgery, Field of Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

[1] Stengelhofen J: The nature and causes of communication problems in cleft palate. In: Sengelhofen J, editors. Cleft Palate: The Nature and Remediation of Communication


**Provisional chapter**
