Improved nasal breathing through downgraft

[jawguy14]

I wanted to ask what you guys think about the following plan:

I think that I will do a DJS directly, with CCW and a posterior downgraft. A relatively large rotation should be made, with 7mm downgraft so that around 14 degrees rotation is achieved.

I have problems with both, the nasal cavity and the upper airway, which are both too narrow/small. In my unterstanding, the DJS solves both of these Problems due to the downgraft.

Because as I understand it, downgrafting makes the nasal passage longer (i.e. unlike MSE, where the nasal passage becomes wider). Whether wider or longer, in both cases the nasal cavity becomes larger, which I don't think makes any difference.

But since there is no downgrafting in the anterior part, it is almost like a transition from front to back, so that the enlargement of the nasal cavity towards the posterior part of the maxilla is more significant, the further back it is. So it's not a proportional prolongation, the average downgraft (in the example of 7mm posterior downgraft) would be 3.5mm.

Many palate expanders also achieve expansion of around 6, 7, 8mm. But with the palate expansion, it is also not the case that the nasal passage expands completely proportional. It expands more in the lower area (near the nose floor) compared to the area at the top, which is already between the eye sockets. Because not the entire skull is divided down the middle, only the palate is divided (expanded).

In my eyes, an average expansion of 7mm would be similar effective as the 7mm posterior downgraft.

What do you think about this plan. Do you think, that 7mm downgraft would have a similar impact as 7mm expansion?

[GJ]

If you get CCW then the volume increase is going to be in the lower airway, which is what you want for apnea. To get more volume in the upper airway you'd have to move it linearly, though, maybe moving it down would do that, too. I'm not sure on that but it does make sense.

[jawguy14]

Yes, i also thought that a CCW with posterior downgraft really lengthens the nasal passage, making the overall nasal cavity larger.

I wrote to someone on Reddit about it, he said that, in a posterior downgraft, the nasal passage is getting longer due to the bone structure (more in the back, because no anterior downgraft), but the soft tissue, which forms the nasal floor in addition to the bone (hard palate), doesnt changes the position.

Because in comparison to the bone, the soft tissue is not moved down because the soft tissue is A attached to the anterior part of the maxilla and B attached to the pterygoid plate, which in most cases is not influenced by a Lefort 1.

To put it simple, if you look into your nose starting frontal from the nostrils, first comes the anterior part of the maxilla, then the posterior part and then the pterygoid plates. The posterior part is in the middle, and because the soft tissue is connected at the beginning (anterior maxilla) and at the end (pterygoid plates), the soft tissue remains in the same position, because its stretched between A and B.

But that would mean that in the posterior part of the nasal cavity you can push the skin/soft tissue down 7mm (with a 7mm posterior downgraft) until you touch the bone.

According to your understanding, how tightly is the soft tissue (like here on the nasal floor) connected to the bone? Basically it's true that only the bone is moved and the tissue is stretched, but you can feel it in your nose, it's really just a very thin layer of skin on the floor. I can't imagine this 7mm being stretched. It has to tear apart.