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This report describes a new case of popliteal pterygium syndrome (PPS) and also a treatment protocol. The patient presented with the complete complex of PPS and additional abnormalities that have not been described in the literature: a sinus of the upper lip, an extreme hypopoplastic prolabium with aplasia of the vestibule in this area, and a velar pterygium.

The functioning of the orofacial muscular system essentially determines the shape of the jaw and of the dental arch as well as the position of the axis of the anterior teeth. Disturbances of the normal functioning can cause anomalies of the position of teeth or malformations of the bone structure. With the help of the newly developed device "Myometer 160" we now have the possibility to measure the intra- and extraoral forces. We examined 107 persons aged 8 to 37 years. The maximal force was measured by ventral tongue pressure, when the lips were pressed against each other and when a brass button was pulled. In addition clinical results as well as a functional status were ascertained in order to record orofacial dyskinesias. A significant connection between the age respectively the sex of the persons and the determined force was found. However, no clear relationship between the occlusal position respectively the functional anomaly and the results of maximal force was determined. Thus it does not seem sensible to use maximal force measurement within the framework of the determined. Thus it does not seem sensible to use maximal force measurement within the framework of the diagnosis of orofacial dyskinesias.

Objective The palatal aponeurosis is a controversial structure, both in terms of its anatomy and its function. This article points out a pathologic finding in the cleft palate condition that has not been previously described. Design and Method By means of surgical dissections, this study demonstrates in detail that the palatal aponeurosis exists even in cleft palates, but it is disrupted, malpositioned, and folded in two layers. Patients This dissection method has been performed on more than 150 patients with cleft of the hard and soft palate, with or without cleft of the lip and alveolus. At the time of operation, the children were between 6 and 8 months of age. Results It is possible to dissect the two layers of the palatal aponeurosis, to unfold the aponeurosis, and to form a tough tendinous plane. Conclusion For a functional physiologic reconstruction of the cleft palate, it is necessary not only to reconstruct the levator veli palatini and palatopharyngeus muscle slings, but also to approximate and suture the fibers of the palatal aponeurosis to the corresponding fibers of the opposite side after unfolding them in a medio-dorso-cranial direction. In this manner, a continuous palatal aponeurosis can be created, which subsequently can serve as a transmitter of the muscle forces.