Recent Posts1
Functional Surgery Questions / SARPE while MMA for better breathing
« Last post by jawguy14 on Today at 08:15:37 AM »Hello everyone, I have a question regarding SARPE + MMA and can't find an answer to it. You would help me a lot if you answered this question. And sorry for my bad english btw.
I'm planning to have MMA surgery this year with CCW and downgrafting to get my sleep disorder under control. I saw that the surgeon im planning to do the surgery with, sometimes does a SARPE in the same surgery as the MMA. The MARPE would be placed on the palate by an orthodontist a few hours before the surgery.
I think that expanding the nasal cavity in addition to enlarging the upper airway through MMA makes sense because, because on the one hand, I am recessed and have an underdeveloped lower jaw, but I also have a narrow palate and have the typical empty gaps on the left and right when I smile.
So for me it's really about breathing better through the nose, thats why i would do SARPE additionally. But according to my understanding, it is impossible to expand the nasal cavity if an MMA surgery was performed at the same time.
Because in MMA with downgrafting and ccw with lefort 1, the maxilla is completely separated from the skull and then repositioned further down and forward, what creates a gap between the skull and the maxilla, which is why everything is held together with plates. Due to the Lefort cut, only the floor and the very lower part of the nasal cavity is still attached to the maxilla, the larger part of the nasal cavity is now just attached to the skull.
As far as i know, during a normal SARPE without MMA, the surgeon simply cuts the palate down the middle to ensure the split, and also makes a few Lefort 1-like incisions to weaken the overlying bone area to facilitate expansion later. Then the Marpe application is turned up little by little in the weeks after the surgery, which expands the palate.
The difference between these lefort 1 cuts in a normal SARPE in comparison to a SARPE with MMA is, that the maxilla is still connected with the skull, because the maxilla isnt repositioned further down and forward, so there is no gap through an mma-advancement. So in a normal SARPE the expansion still impacts the nasalbreathing, because the maxilla is still connected to the skull.
So is it right, that the expansion of the palate doesnt improve the nasal breathing in the scenario with SARPE+MMA at all? Because then, the expansion would only affect the maxilla and not the nasal cavity due to the gap. I would then just do the MMA and see, if my sleep problems get solved through just increasing the upper airway. If its not enough, i would wait, until the bone heals completely and then after maybe 2 years expand my palate with mse+ease or something like that. What do you think of that?
Thank you in advance.
I'm planning to have MMA surgery this year with CCW and downgrafting to get my sleep disorder under control. I saw that the surgeon im planning to do the surgery with, sometimes does a SARPE in the same surgery as the MMA. The MARPE would be placed on the palate by an orthodontist a few hours before the surgery.
I think that expanding the nasal cavity in addition to enlarging the upper airway through MMA makes sense because, because on the one hand, I am recessed and have an underdeveloped lower jaw, but I also have a narrow palate and have the typical empty gaps on the left and right when I smile.
So for me it's really about breathing better through the nose, thats why i would do SARPE additionally. But according to my understanding, it is impossible to expand the nasal cavity if an MMA surgery was performed at the same time.
Because in MMA with downgrafting and ccw with lefort 1, the maxilla is completely separated from the skull and then repositioned further down and forward, what creates a gap between the skull and the maxilla, which is why everything is held together with plates. Due to the Lefort cut, only the floor and the very lower part of the nasal cavity is still attached to the maxilla, the larger part of the nasal cavity is now just attached to the skull.
As far as i know, during a normal SARPE without MMA, the surgeon simply cuts the palate down the middle to ensure the split, and also makes a few Lefort 1-like incisions to weaken the overlying bone area to facilitate expansion later. Then the Marpe application is turned up little by little in the weeks after the surgery, which expands the palate.
The difference between these lefort 1 cuts in a normal SARPE in comparison to a SARPE with MMA is, that the maxilla is still connected with the skull, because the maxilla isnt repositioned further down and forward, so there is no gap through an mma-advancement. So in a normal SARPE the expansion still impacts the nasalbreathing, because the maxilla is still connected to the skull.
So is it right, that the expansion of the palate doesnt improve the nasal breathing in the scenario with SARPE+MMA at all? Because then, the expansion would only affect the maxilla and not the nasal cavity due to the gap. I would then just do the MMA and see, if my sleep problems get solved through just increasing the upper airway. If its not enough, i would wait, until the bone heals completely and then after maybe 2 years expand my palate with mse+ease or something like that. What do you think of that?
Thank you in advance.