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Osaka Medical Center and Research Institute for Maternal and Child Health

Conditions Treated
Cleft Lip and Palate.
Although it is recommended that surgery to repair a cleft lip and palate be performed during
infancy, the condition can be repaired up to the age of 6. At this moment, we are unfortunately
unable to admit patients with other complications.

Treatment Methods (Early Two-Stage Palatoplasty Using the Furlow Method in Cleft Lip and Palate Treatment)

The lips and roof of the mouth are formed during the first 4-12 weeks of the fetal stage. If abnormalities occur during this period, the child may be born with a cleft on the lip and/or the roof of the mouth. This condition is called cleft lip and palate. Cleft lip and cleft palate usually occur in combination, although they may occur separately in some cases. Among various symptoms, there are 3 main disorders: (1) facial deformity; (2) speech impediments; and (3) poor dental bite. A well-balanced multidisciplinary approach combining surgery, speech training, and orthodontic therapy is necessary in the treatment of cleft lip and palate. In particular, the results of the first surgery greatly affect the subsequent performance results.

Many therapy methods for cleft lip and palate developed in Europe and the U.S. are used internationally. However, since the jaws of Asians develop more slowly and wounds heal more slowly than those of Caucasians, it was difficult to achieve sufficient benefits using conventional Western therapies. Ordinarily, the first step in surgery is to close the posterior upper jaw (maxilla; soft palate) for an infant at approximately age 1, and after the development of the jaw takes place, the second step is to close the anterior upper jaw (hard palate) between the ages of 5 and 6. When this two-stage palatoplasty method is applied, there is a higher tendency for speech impediments to remain because the hard palate is left open between the first and the second surgeries. However, the second surgery has not been performed at the early stage until now due to the concern that it might be harmful to jaw development.

In order to rectify this problem, our department director at the center, Dr. Juntaro Nishio, and his colleagues developed the method of early two-stage palatoplasty using the Furlow method. In this procedure, developmental defects of the upper jaw can be prevented, and excellent linguistic development can be achieved by performing the first and second surgeries at approximately age 1 and age 1.5, respectively. When we use this method with Asian patients who have slower jaw development, including Japanese, we are able to obtain significantly successful results, which demonstrates that our method is comparable to the northern European method that produces effective results in Caucasians.

Here at our hospital, we have already performed this procedure on a number of patients, although it is rarely performed in other medical institutions because it requires a fine-tuned and delicate set of skills as well as a considerable amount of experience.

Features of Our Center

As a specialty hospital for perinatal period/children‘s diseases, our center has advanced diagnostic/therapeutic techniques that have been acquired in each specialty clinical department over the years. We pride ourselves on our top-class achievements in surgery and the number of our patients in Japan.

Surgery Results

(Year) 2008 2009 2010 2011
Cleft Lip
Surgery #1
56 49 48 49
Cleft Palate
Surgery #1
77 71 58 70

Osaka Medical Center and Research Institute for Maternal and Child Health and Sahlgrenska University Hospital (Gothenburg, Sweden): A Comparison of the Development of the Posterior Upper Jaw

Our oral surgery department was established in 1987 as a specialty department for the comprehensive care of cleft lip and cleft palate. We utilize our resources to the fullest to manage our center by looking at all aspects of children’s diseases, which is a special feature of our hospital. We solve problems and disorders related to cleft lip and cleft palate on a step-by-step basis. We have also established a system for long-term follow-up conducted by many of our specialists and staff, in order to ensure the child’s anxiety-free growth. Our center receives over 90 new patients annually, and it ranks as one of the top 3 hospitals in Japan in our specialty. Also, over 200 surgeries for cleft lip and cleft palate are performed per year. Our performance results have been outstanding compared to other hospitals.

Due to the fact that Japanese have different craniofacial bone structure and skeletal morphology and different linguistic functions compared to Caucasians, it would be difficult to achieve effective results for Japanese by applying European/American therapeutic methods as-is. However, because we have extensive experience with Japanese patients at our center, we expect that we can achieve effective treatment results for patients other than Asians.

A Message to International Patients from Our Center

Dr. Masanori Fujimura
Dr. Masahiro Fukuzawa
President

Dr. Juntaro Nishio
Dr. Juntaro Nishio
Director, Department of Oral Surgery

Our center, and the oral surgery department in particular, was established with the objective of providing comprehensive therapy for cleft lip and cleft palate. A very large number of palatoplasties have been performed for cleft lip and cleft palate, and we have developed our own method of early 2-stage palatoplasty, which has provided good results in phonological linguistic function due to the positive development of the upper jaw. Successful surgeries in our department are comparable to those of most northern European hospitals based on occlusion evaluation using global standards. Evaluation of occlusion verified that successful surgeries at our department using this method are comparable to those of most northern European hospitals, even for Asian patients for whom the treatment is normally difficult. We are one of the pediatric hospitals in Japan committed to making an international contribution as an institution designated as a WHO Collaborative Centre. We would like to offer state-of-the-art healthcare and continue our services to our international patients.

  • Yamanishi T, et al. Early two-stage double opposing Z-plasty or one-stage push back palatoplasty?: Comparisons in maxillary development and speech outcome at 4 years of age. Ann Plast Surg. 2011; 66: 148-53.
  • Nishio J, et al. Early two-stage palatoplasty using modified Furlow's veloplasty. Cleft Palate- Craniofacial J. 2010; 47: 73-81.
  • Yamanishi T, et al. Effect on maxillary arch development of early 2-stage palatoplasty by modified furlow technique and conventional 1-stage palatoplasty in children with complete unilateral cleft lip and palate. J Oral Maxillofac Surg. 2009; 67: 2210-6.

Overview of the Treatment Schedule (Model Case: Cleft Lip and Cleft Palate)

Currently, it takes approximately 3 months from the time the decision is made for a child’ s admittance to our hospital to the time of his/her surgery.

We would like you to consult us concerning admittance of your child as early as possible after birth. We require in advance a picture of the child’ s face and the required data to confirm that the child has no other complications.

Overview of Treatment Schedule

Photos

External View of Our Center Waiting Room
External View of Our Center Waiting Room
Hospital Contact Information
Phone (for international visitors):
+81-725-56-1220
Email: kikakushi@mch.pref.osaka.jp
Established 1981
Clinical Departments
Oral and Maxillofacial Surgery, Pediatric Surgery, Neurosurgery, Urology, Plastic Surgery, Orthopedic Surgery and Rehabilitation, Ophthalmology, Otorhinolaryngology (Ears, Nose, and Throat), Orthopedics, Cardiovascular Surgery, Anesthesiology and Intensive Care, Obstetrics, Neonatology, Maternal Medicine, Gastroenterology and Endocrinology, Nephrology and Metabolism, Hematology and Oncology, Pediatric Neurology, Developmental Pediatrics, Pediatric Cardiovascular Medicine, Medical Genetics
Payment Methods
Credit Card (VISA, American Express, DC, JCB, MasterCard)

map

Address
840 Murodo-cho, Izumi-shi, Osaka 594-1101
5 minutes on foot from
the Semboku Rapid Railway Komyoike Station
40 minutes from
Kansai International Airport by car
URL
http://www.mch.pref.osaka.jp/