Hearing, speech and written communication posses a high rank in our civilization. Nearly the whole interpersonal communication takes place on verbal terms. Basic preconditions for a normal speech acquirement are aside from a functioning organ of hearing an undisturbed hearing development. The middle ear ventilation is insufficient with 90% of the children with Lip-Jaw-Palate-Velum-Nose-Vomer-Deformity respectively Velum-Palate-Vomer-Deformity. The precise pathogenic mechanism of the Eustachian tube opening is not yet sufficiently known. Well examined indeed are the consequences: With a missing ventilation a negative pressure is arising in the tympanum, leading to an oedema of the mucosa. The chronicity of a ventilation failure leads to an epithelial metaplasia of the tympanum mucosa towards myxopoetic epithelial tissue. The firstly thin liquid, runny exudation will thicken consequently . Trough the pathological low pressure respectively the aggregation of liquid in the tympanum the mobility of the tympanic membrane and the ossicular chain is restricted. Consequently middle ear deafness is ensuing. The sound conduction is delayed and the sound intensity reduced. Chronic middle ear diseases like the ear drum perforation or the cholesteatoma might be developing. A long lasting hearing impairment during childhood may lead to sincere consequences like disorders of speech development, general developmental diseases and psychosocial disorders; therefore, on patients with a Lip-Jaw-Palate-Velum-Nose-Vomer-Deformity a consistent ear microscopical and audiological supervision as well as the therapy of the Otopathologica is imperative.

The Lip-Jaw-Palate-Cleft is the most common face deformity among humans. It is mostly neglected, that those deformations include defects of the inner and outer nose. Primary therapeutic concepts chiefly only describe a correcting of lip and palate. The correction of the inner and outer Nose inevitably is a part of primary habilitation of the patient with a deformity of lip, jaw, palate and nose. En route this should get its obligatory position within the primary evaluation, documentation, education and operation planning. The correct primary therapy with orosurgery is premissive for an optimal correction of the nose deformity, including the linking of the nasal septum via a mucoperiosteal flap to the endonasal palate mucoperiosteum for the construction of two separate nasal main cavities, along with the rest hole free sealing between oral and nasal cavities and the osseous development of the alveolar process and hard palate. For the attending surgeon the operational techniques of the nose correction are utterly demanding. only the open access provides the optimal vision of the misformed cartilaginous and osseous structures. As in other sectors it should be the objective of the operative corrections of inner and outer nose malformations with a Lip-Jaw-Palate-Velum-Nose-Vomer-Deformity to achieve approximately normal anatomical arrangements. In contrast to the cosmetic nose corrections the aim of creating symmetrical conditions and additionally with a unilateral abnormality is to be attained only quite compelling, due to the sometimes exceptional deformity of the osseous-cartilaginous structures . The abnormalities of covering skin and connective tissue formations are equally elaborate with integral correction. The unphysiological repair with inserting angled bone chips or the like often lead to an unsatisfactory result with a rigid and unnatural appearance.