Author Topic: Efficacy of MSE vs. multi segment lefort for nasal passage expansion  (Read 9791 times)

tyler93245

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #15 on: May 06, 2021, 10:56:26 PM »
Absolutely no reason you cannot do MSE after jaw surgery.
That's the first I've heard it's possible.

Regardless, Dr. Gunson told me himself it was not possible and I need to work under his guidelines.

ArtVandelay

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #16 on: May 09, 2021, 12:06:27 PM »
That's the first I've heard it's possible.

Regardless, Dr. Gunson told me himself it was not possible and I need to work under his guidelines.

I would guess you need to have upper plates removed to do so so it complicates things

But if you need it done definitely get it done before, it'll make the bite more precise.

Luis_McLovin

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #17 on: May 10, 2021, 02:37:05 AM »
Absolutely no reason you cannot do MSE after jaw surgery.

I appreciate your confidence, with seeing-is-believing, please does there exist an anecdotal account of this treatment path? I’m considering jaw work but am unsure if I wish to do MSE I need to do before or after and I’ve yet to find hard assurances.

Is there a past treatment profile of a person?

thedude

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #18 on: May 10, 2021, 04:13:39 PM »
I appreciate your confidence, with seeing-is-believing, please does there exist an anecdotal account of this treatment path? I’m considering jaw work but am unsure if I wish to do MSE I need to do before or after and I’ve yet to find hard assurances.

Is there a past treatment profile of a person?

https://m.youtube.com/watch?v=vsqs8KAqSzE&t=32s
15 minute mark

Edit:
I am just saying it is technically possible, not that it’s a good idea. If you are doing jaw surgery without braces I don’t see why the order matters at all. If you are getting braces for jaw surgery it would be silly not to do the palate expansion first since you’ll need braces a second time otherwise. I was thinking more like if you are doing jaw surgery and already pretty far along and expect a pretty good outcome, don’t feel like you are making an irreversible mistake by not expanding the palate first. It’s still an option later - just a little less convenient.

An argument in favor of waiting is that unlike with jaw surgery there is a lot of change and innovation happening with upper jaw expansion. I think the European expanders I talked about earlier and minimally invasive methods are game changing. If you can’t afford to travel to a doctor that does it maybe it’s worth the wait. I don’t find traditional MSE to be all that compelling a surgery.
« Last Edit: May 11, 2021, 01:19:41 AM by thedude »

tyler93245

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #19 on: July 28, 2021, 11:17:16 AM »
Kasey Li does this and I'm sure some other things too and calls the whole thing "EASE:" https://www.sleepapneasurgery.com/surgical-solutions-for-adults-ease/ Dr. Li by the way is an absolutely incredible surgeon and just all around good person.
An update for anyone who's interested:
I'm getting EASE surgery with Dr. Kasey Li in about a week. I looked very closely into all expansion options including MSE and it's clear to me now that Dr. Li in on the front lines of innovation in this field. His surgery techniques are on a totally different level than other surgeons. He leaves the other surgeons in the dust.

The most important thing I can say about the surgery (This is info you can't find well elaborated anywhere online) is that the VERTICAL expansion pattern is better than any other expander (Don't confuse this with the horizontal expansion pattern, i.e. what the lectures posted early in this thread address). The expansion mostly affects the midface, not the teeth. It's hard to explain, but here's a logical truth: the teeth can only be expanded to a certain point before the maxillary arch is too wide for the mandibular arch. If MSE and EASE are compared when expanded to this limit, EASE leaves a smaller tooth gap. That should tell you all you need to know about the veritcal expansion pattern (something rarely spoken about). The result with EASE is more expansion of the "real" maxilla (and importantly, the nasal passageway) than MSE offers. I believe this is due to Dr. Li's surgical technique of cutting certain parts of the bone and SCORING other parts (to weaken points of resistance). In short, MSE doesn't actually expand the bone the way it's supposed to (like when you see a demonstration video of a model skull being neatly split in half along the midpalletal suture). EASE does what MSE promises to do, but better.

Dr. Li also gave me anecdotal experience of 3 piece leftort 1s WORSENING the nasal passageway due to various factors (which I'm not smart enough to extensively elaborate on). He mentioned that the teeth will go where they want to go during recovery of jaw surgery, which sometimes means the cut up maxilla is rearranged during healing from the position it was placed in with plates. I cannot say this is universally true for all surgeons, but it's something to consider.

Anyways, nothing to report yet as far as personal experience goes- but things are looking good. I'll update with pictures once the expansion is done.
« Last Edit: July 28, 2021, 11:41:50 AM by tyler93245 »

tyler93245

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #20 on: March 06, 2022, 05:26:03 PM »
An update for anyone who's interested:
I have about 10mm of expansion so far with EASE. This surgery has been great so far and is helping my nasal breathing ALOT. I can definitely recommend this surgery.

thedude

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #21 on: March 08, 2022, 06:41:17 PM »
Good to hear it helped. 10mm is impressive. How big a gap did you end up with?

tyler93245

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #22 on: March 19, 2022, 12:28:47 PM »
Good to hear it helped. 10mm is impressive. How big a gap did you end up with?
I ended up with no gap between my front teeth since my front teeth drifted back together during expansion. The 1cm worth of gaps was distributed through my other front teeth. The expansion ranged from 10mm anterior to 3-4mm posterior. My expansion wasn't parallel but the limit was the rear teeth, regardless, so I expanded as much as I could.

quantumfinance

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Re: Efficacy of MSE vs. multi segment lefort for nasal passage expansion
« Reply #23 on: June 06, 2022, 09:19:32 PM »
Absolutely no reason you cannot do MSE after jaw surgery.

you can also use a regular expander which has been routinely used to expand maxillae