SARPE and nasal breathing resistence.

[Ben]

Ok so I've got serious issues with nasal breathing resistance, so to those who've had SARPE did you notice a long lasting (permanent) improvement in your ability to breathe through your nose?
Thanks

[dantheman]

Ok so I've got serious issues with nasal breathing resistance, so to those who've had SARPE did you notice a long lasting (permanent) improvement in your ability to breathe through your nose?
Thanks

Compared to a turbinate reduction I would think the SARPE would win hands down in terms of long term assurance of decreased nasal resistance. You are essentially expanding the nasal cavity and giving the turbinates more room. There must be literature on this, no?

[Ben]

Compared to a turbinate reduction I would think the SARPE would win hands down in terms of long term assurance of decreased nasal resistance. You are essentially expanding the nasal cavity and giving the turbinates more room. There must be literature on this, no?

No decent studies done on it in full grown adults, pretty complex to evaluate nasal breathing + lots of variables.
I'm with you on what you've said above, but my maxillofacial surgeon doesn't believe it does, but then he thinks it's just dandy to be breathing through the mouth and live life with a constantly stuffy nose...moron

[dantheman]

No decent studies done on it in full grown adults, pretty complex to evaluate nasal breathing + lots of variables.
I'm with you on what you've said above, but my maxillofacial surgeon doesn't believe it does, but then he thinks it's just dandy to be breathing through the mouth and live life with a constantly stuffy nose...moron

Yes that is bulls**t. I have become neurotic about having to breathe through my mouth at night. When i use a decongestant I sleep much better. Usually wake up with the blankets still on and the same part of the bed. If i'm stuffed up I snore like crazy, have an incredibly disrupted sleep, and a parched mouth. How is your breathing during the day?

[Ben]

Yes that is bulls**t. I have become neurotic about having to breathe through my mouth at night. When i use a decongestant I sleep much better. Usually wake up with the blankets still on and the same part of the bed. If i'm stuffed up I snore like crazy, have an incredibly disrupted sleep, and a parched mouth. How is your breathing during the day?

It just feels so unhealthy to me to mouth breathe..I've noticed that people who mouth breathe are really struggling in their lives but they won't listen to me when I tell them their anxiety lack of sleep general life problems could be caused by a blocked nose they just switch off, but  once a person has a comparison of a clear nose for a few days or weeks I feel  it will become clear to them that a 'blocked' nose can be a major problem. It's a shame that these people just continue to mouth breathe without ever trying to make a real effort to nose breathe so how will they ever know.
It took me a long time to work out that my extreme anxiety was being caused by it, because no one ever told me that it isn't good for us to breathe through the mouth. I didn't even know we were designed to breathe through our noses. I just thought my blocked nose was separate from all my other problems.
I get the same thing with the blankets getting all messed when I'm stuffy. During the day the stuffiness of my nose varies, just like it does at night although I've noticed that colder wet weather can block up my nose pretty quick but there always seems to be exceptions. My own feeling is that my airways surrounding my turbinate's are underdeveloped so any kind of stress encountered in the environment or diet or emotional just causes a little swelling then I'm mouth breathing again. I get really pissed off because people who have normal function of their noses cannot sympathise they really don't know what it is like to live without the nose functioning properly. People have suggested that I take a sleep study to see if I have sleep APNEA, this is upsetting as I know that it is my blocked nose that is causing my problems and the doctors who run the sleep tests have trouble picking up on this, even they don't seem to realise the evils of mouth breathing.
I've been trying everything under the sun to improve my situation. I was gutted when my jaw expansion surgery left me with this (see picture). I went to a grain free diet 7 days ago so I'll see if my nose stays clear enough for longer than 2 months then I'll start to feel quite happy that I cold be on to something that could be of benefit.

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[x]

It just feels so unhealthy to me to mouth breathe..I've noticed that people who mouth breathe are really struggling in their lives but they won't listen to me when I tell them their anxiety lack of sleep general life problems could be caused by a blocked nose they just switch off, but  once a person has a comparison of a clear nose for a few days or weeks I feel  it will become clear to them that a 'blocked' nose can be a major problem. It's a shame that these people just continue to mouth breathe without ever trying to make a real effort to nose breathe so how will they ever know.
It took me a long time to work out that my extreme anxiety was being caused by it, because no one ever told me that it isn't good for us to breathe through the mouth. I didn't even know we were designed to breathe through our noses. I just thought my blocked nose was separate from all my other problems.
I get the same thing with the blankets getting all messed when I'm stuffy. During the day the stuffiness of my nose varies, just like it does at night although I've noticed that colder wet weather can block up my nose pretty quick but there always seems to be exceptions. My own feeling is that my airways surrounding my turbinate's are underdeveloped so any kind of stress encountered in the environment or diet or emotional just causes a little swelling then I'm mouth breathing again. I get really pissed off because people who have normal function of their noses cannot sympathise they really don't know what it is like to live without the nose functioning properly. People have suggested that I take a sleep study to see if I have sleep APNEA, this is upsetting as I know that it is my blocked nose that is causing my problems and the doctors who run the sleep tests have trouble picking up on this, even they don't seem to realise the evils of mouth breathing.
I've been trying everything under the sun to improve my situation. I was gutted when my jaw expansion surgery left me with this (see picture). I went to a grain free diet 7 days ago so I'll see if my nose stays clear enough for longer than 2 months then I'll start to feel quite happy that I cold be on to something that could be of benefit.

This is interesting. I can 100% relate on the anxiety and also have some serious nasal breathing issues, with a deviated septum and a 75%(?) right nasal deflection, as well as enlarged adenoids as a kid so I've been mouth breathing my whole life. I was recommended a turbinectomy and septoplasty by an ENT, do you think that in conjunction with the SARPE would be the best approach? I do wonder if upper jaw surgery should come before or after the nasal surgeries, and how they impact each other.

Are you saying you started mouth breathing after the jaw expansion? And you never did before? Could you give sort of a before/after account of how you felt in general, mood-wise and health-wise. I'm pretty interested in this topic, and curious as to how much it could potentially improve my mood but I don't want unreasonable expectations either.

[Ben]

This is interesting. I can 100% relate on the anxiety and also have some serious nasal breathing issues, with a deviated septum and a 75%(?) right nasal deflection, as well as enlarged adenoids as a kid so I've been mouth breathing my whole life. I was recommended a turbinectomy and septoplasty by an ENT, do you think that in conjunction with the SARPE would be the best approach? I do wonder if upper jaw surgery should come before or after the nasal surgeries, and how they impact each other.

Are you saying you started mouth breathing after the jaw expansion? And you never did before? Could you give sort of a before/after account of how you felt in general, mood-wise and health-wise. I'm pretty interested in this topic, and curious as to how much it could potentially improve my mood but I don't want unreasonable expectations either.

Hey man, my jaw surgery was a complete cock up I went into it without knowing enough. If I could go back and do it again, I would have opted for SARPE 2 stage type procedure to firstly widen and then advance my maxilla. My breathing has been worse since my surgery which I had 8 months ago, but it was never perfect. I have learnt how to live with it better I still have periods of stuffy nose often and it leaves me feeling hopeless because I don't want to go on with it struggling to breathe, but then it always seems to come a bit clearer and I have a better sleep and feel good about life again.
 It is my personal thought that SARPE expanded as slowly as possible will create some more room in the sinus cavity and even if it was only .5mm it should mean a decent improvement, a reduction in Nasal resistance. I've also thought about slow non surgical expansion and I'm currently interested in NCR in conjunction with a removable palatal expander. I'm not convinced that an expander that pushes on the teeth is the best way to apply pressure to expand the maxilla, but then pushing on the soft tissue is likely to create irritation but maybe it would be acceptable to do it for 30mins or an hour a day. I'm not sure but I want to try things and find out what works.
I think removing turbinate material should come after SARPE perhaps as a last resort and it should be approached with caution. Empty nose syndrome scares the muck out of me.  If our mouths cannot fit all 32 teeth without crowding then how can I sinus have the full space for the turbinate's to operate as nature intended, it just makes sense to me that those two things go hand in hand. I don't think removing teeth is an acceptable way to improve a bite same goes with turbinate reduction, I'd rather make more room if possible.

[x]

Hey man, my jaw surgery was a complete cock up I went into it without knowing enough. If I could go back and do it again, I would have opted for SARPE 2 stage type procedure to firstly widen and then advance my maxilla. My breathing has been worse since my surgery which I had 8 months ago, but it was never perfect. I have learnt how to live with it better I still have periods of stuffy nose often and it leaves me feeling hopeless because I don't want to go on with it struggling to breathe, but then it always seems to come a bit clearer and I have a better sleep and feel good about life again.
 It is my personal thought that SARPE expanded as slowly as possible will create some more room in the sinus cavity and even if it was only .5mm it should mean a decent improvement, a reduction in Nasal resistance. I've also thought about slow non surgical expansion and I'm currently interested in NCR in conjunction with a removable palatal expander. I'm not convinced that an expander that pushes on the teeth is the best way to apply pressure to expand the maxilla, but then pushing on the soft tissue is likely to create irritation but maybe it would be acceptable to do it for 30mins or an hour a day. I'm not sure but I want to try things and find out what works.
I think removing turbinate material should come after SARPE perhaps as a last resort and it should be approached with caution. Empty nose syndrome scares the muck out of me.  If our mouths cannot fit all 32 teeth without crowding then how can I sinus have the full space for the turbinate's to operate as nature intended, it just makes sense to me that those two things go hand in hand. I don't think removing teeth is an acceptable way to improve a bite same goes with turbinate reduction, I'd rather make more room if possible.

Thanks for the response. So are you saying you had a multi-piece LeFort to widen your maxilla and it has since relapsed? And you wish you had gone the SARPE route? Again, this is very relevant to me as I'm facing that decision as well so I really appreciate you sharing your experience. I've heard SARPE is much more reliable when it comes to long term stability, so all signs point to that being the more effective procedure. What's an NCR btw? I had a palatal expander as a kid when I was still growing but relapsed back to my narrow upper palate w/ a crossbite, I'm not sure if I could expect a secure long term result if the soft tissue is combating the new width of the upper jaw, ya know? I feel like this is an area under appreciated by surgeons, or perhaps they can appreciate it but it's out of the bounds of their control and they willingly choose to keep us in the dark about it.

I read up a bit about empty nose syndrome and learned it is a pretty rare complication these days, provided you go to an experienced surgeon. Nothing like the frequency with which it used to occur 15-20 years ago. But still, I agree that it seems widening the maxilla first is the better approach. If you're going to address it no matter, might as well see if it clears up the issue on it's own right?

Anyways sorry to hear what you're going through, I can relate although my breathing issues might not be as bad as yours. They're still draining.

[orthoo]

I have had turbinectomy about a year ago and developed moderate symptoms of Empty nose syndrome. I am wondering whether I should have done the right thing in expansion of the palate but I wonder if I did this now im sure it would make it worse. I have a narrow palate so basically this 'treatment' was completely uneccisary IMO. I have wide nasal passages with the narrowest top jaw so if i did widen my maxilla for cosmetic reasons it would result in full blown wide empty nasal cavity. What are my options?

[x]

I have had turbinectomy about a year ago and developed moderate symptoms of Empty nose syndrome. I am wondering whether I should have done the right thing in expansion of the palate but I wonder if I did this now im sure it would make it worse. I have a narrow palate so basically this 'treatment' was completely uneccisary IMO. I have wide nasal passages with the narrowest top jaw so if i did widen my maxilla for cosmetic reasons it would result in full blown wide empty nasal cavity. What are my options?

Goddamnit.

Sorry to hear. I wish I could help, but I don't really know. Speak to an ENT and a maxillofacial surgeon I suppose.

[Ben]

I had a lefort one 3 piece segmented osteotomy. It didn't relapse, it simply failed to gain any expansion it also impacted my jaw and insufficiently advanced it. SARPE followed by lefort one is more stable and a much simpler procedure, I wish my surgeon had told me this. I think maintaining the correct resting tongue position is important to the long term stability of the upper arch it is only  a light force but it is more or less constant. This is where the mouth breathing thing comes in. If your mouth breathing your tongue sits in the wrong position, this is especially important in children who are developing fast. I'm sure surgeons keep a lot to themselves there is money at stake here.

NCR is neuro-cranial restructuring, basically you stick a balloon into 1 of six of the airways and inflate it quickly which over time is supposed to release the bones of the skull allowing them to move into a more ideal position.
 
ENS probably often goes undiagnosed and it is serious enough to make people chose to end their lives and I've read it can take a long time for symptoms to show up. My ENT doctor said it was more common in cold climates so I didn't need to worry because the weather in New Zealand is quite mild. I'm thinking what if I want to move to a cold climate?

[x]

I had a lefort one 3 piece segmented osteotomy. It didn't relapse, it simply failed to gain any expansion it also impacted my jaw and insufficiently advanced it. SARPE followed by lefort one is more stable and a much simpler procedure, I wish my surgeon had told me this. I think maintaining the correct resting tongue position is important to the long term stability of the upper arch it is only  a light force but it is more or less constant. This is where the mouth breathing thing comes in. If your mouth breathing your tongue sits in the wrong position, this is especially important in children who are developing fast. I'm sure surgeons keep a lot to themselves there is money at stake here.

NCR is neuro-cranial restructuring, basically you stick a balloon into 1 of six of the airways and inflate it quickly which over time is supposed to release the bones of the skull allowing them to move into a more ideal position.
 
ENS probably often goes undiagnosed and it is serious enough to make people chose to end their lives and I've read it can take a long time for symptoms to show up. My ENT doctor said it was more common in cold climates so I didn't need to worry because the weather in New Zealand is quite mild. I'm thinking what if I want to move to a cold climate?

Yup I know the importance of keeping the tongue in the upper palate. I am hoping this will become a natural resting position after surgery and not something I'll have to conscientiously practice positioning. Guess I'll be doing the SARPE followed by LeFort route.

Not so sure about NCR, I did a quick Google search and the science behind it seems questionable.

Does a septoplasty carry the risk for ENS as well?

[Ben]

Yup I know the importance of keeping the tongue in the upper palate. I am hoping this will become a natural resting position after surgery and not something I'll have to conscientiously practice positioning. Guess I'll be doing the SARPE followed by LeFort route.

Not so sure about NCR, I did a quick Google search and the science behind it seems questionable.

Does a septoplasty carry the risk for ENS as well?

Sounds like a smart Idea, another thing 3 piece did was leave most of my upper teeth and gums with much limited feeling. It also stressed the crap out of my lateral incisors which I can't feel anymore to make room for the cuts to create the front segment. Now they are very loose in the gum.
Don't get me wrong I love science but I think science and capitalism may not be the best team for the betterment of humanity. I find myself often thinking of the amount of variables involved in the human body and the complex relationships between its parts and I think any kind of study involving scientific process is going to be expensive... Who is going to pay for it and why would they?
It isn't going to cost me much to do NCR anyway, just a blood pressure bulb $3 and some finger cots and it seems safe and logical enough, so I figured I'd give it a go and see what happens. I can't simply have another surgery now, I've got a long complicated process a head to get to where I would be if I'd just had SARPE, and there is the money involved.

[Ben]

I understand what you mean, you're very smart to approach this with caution it is a very serious thing to do.
My surgeon is based in Auckland New Zealand so don't you'd be very unlucky to encounter him.