Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are complications of a cleft lip and cleft palate?
There are a number of complications that may affect infants and children with
cleft lip and palate. These include the following:
Feeding problems: Because of the
anatomical defects, it may be very difficult for newborn infants to breastfeed
successfully. The abnormal separation of the upper lip makes it very difficult
for the newborn to obtain a good seal that is necessary for a successful nursing
experience. Routine nipples for bottle-feeding present the same problem;
however, specialized bottles and nipple systems exist that facilitate effective
nutrition. Those children with a cleft palate are commonly fitted with a
removable artificial palate very early in life. This device limits the
possibility of passage of liquids through the defect into the nostrils as well
as also facilitating the ability to efficiently suck on the specialized nipple.
Ear infections/hearing loss: Children with cleft palate are more likely to
have recurrent ear infections and associated fluid accumulation in the inside of
the eardrum. In order to limit these issues, most children with cleft palate
have PETs ("tubes") placed through the eardrum during their early months.
Speech problems: As would be expected, the malformations associated with cleft
palate and lip may impact articulation. The most common issue tends to be a
nasal quality to their voice. Corrective surgery may lessen these speech issues
but most children with cleft lip and/or palate benefit from formal speech
Dental problems: Children with cleft lip and/or palate commonly have
issues with missing and malformed teeth and commonly require orthodontic
treatments and occasionally oral surgery if the upper jawbone (maxilla) has
impaired function (such as improper placement and abnormal positioning of