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A combined cleft palate and craniofacial was organized at Chang Gung Memorial Hospital, Taipei, in 1980. The team includes four plastic surgeons, four orthodontists, one prosthodontist, one otolaryngologist, one pediatrician, two speech pathologists, one social worker, one psychologist, two neurosurgeons, one ophthalmologist and a medical artist. Weekly combined clinics and meetings are held regularly to evaluate cleft lip/palate and all craniofacial cases. The team members set up treatment plans for each cleft palate and craniofacial patient, and follow up the patient's facial growth with critical evaluation of the result, complication, relapse and patient's or parent's satisfaction after surgery. Parents' support groups, summer speech camps and conferences between patients, parents and other public resources are held regularly. Longitudinal studies are strictly carried out on specific groups of cleft patients and major craniofacial patients.

The Widmaier-Perko palatoplasty was evaluated in post alveolar clefts. The speech results of 42 Chinese patients revealed 78.5% as having acceptable speech. In post alveolar clefts of the soft palate only 80% had acceptable speech compared to 76% acceptable speech for clefts of the soft and hard palate. This compared favourably with other similar reported studies. No dental occlusal or growth disturbances were noted. There was significant middle ear disease in the patients examined. This type of palatoplasty does not disturb the palatine bone periosteum and may be helpful in preventing growth disturbances.

Prior to 1982, children with cleft palate received delayed hard palate closure at Chang Gung Memorial Hospital. In this treatment, soft palate is usually repaired with Widmaier palatoplasty at about 18 months with surgery; hard palate is not closed until the age of 6 or 7. Our previous study indicated that the articulation skill of the cleft palate children before delayed hard palate closure is generally far inferior to the non-cleft children of the same age. Further investigation was carried out to look into the articulation proficiency and error patterns of the cleft palate children undergoing delayed hard palate closure. Data of 47 children (32 boys, 15 girls) were analyzed. Articulation proficiency was compared in four phoneme categories: nasals, plosives, fricatives and affricates. The results indicated that affricates are most difficult for Chinese cleft palate children to pronounce. At age 5, just before the hard palate closure, none of the phonemes is produced correctly except nasals.

Cephalometric radiographs of a sample of complete unilateral cleft lip and palate patients (15 males, 15 females, aged 6.5 to 7.5 years) were analysed. In most cases, an adhesion cheiloplasty was done at 3 months of age, followed by definitive cheiloplasty at 6 to 12 months, then by posterior palatoplasty at 1.5 years. The hard palate was not repaired till the age of 5-7 years. This preliminary study indicated that: (1) The growth of maxilla and mandible shows no sex difference, except the anteroposterior maxillary length, which is longer in the cleft males. (2) The maxilla of our group is more retruded than that of normal noncleft children. (3) The mandibular growth is essentially normal except the higher mandibular plane in the cleft females. (4) The intermaxillary relation and skeletal profile of the cleft males are more favourable than in the early closure group.