Which is better MSE or turbinate reduction/septoplasty for nasal breathing issues?

[MSEinvestigator]

.

 

[Sanguinius]

Bump

 

[Deleted member 2816]

Google Empty Nose Syndrome. Your welcome. Don’t do a turbinate reduction at all costs

 

[MSEinvestigator]

Google Empty Nose Syndrome. Your welcome. Don’t do a turbinate reduction at all costs

Yo, how’s the MSE going?

 

[Deleted member 13710]

If you really have a nasal blockage from oversized turbinates, turbinate reduction is the only thing that will fix that. I would not get too concerned with gimmick procedures like MSE if you have an actual medical issue.

 

[MSEinvestigator]

If you really have a nasal blockage from oversized turbinates, turbinate reduction is the only thing that will fix that. I would not get too concerned with gimmick procedures like MSE if you have an actual medical issue.

How is the MSE a gimmick?

 

[greyrock45]

If you have alrge turbinates do turbinate reduction, if you have a diviated septum do septoplasty, if you don't have any real conditions try MSE i guess. Also check if you have enlarged Adenoids, those also often lead to nasal breathing issues.

 

[Deleted member 13710]

How is the MSE a gimmick?

It's a new procedure practiced by only a handful of professionals worldwide with very controversial results. It's not like bimax, which is a standard surgery for maxillofacial surgeons that is taught as part of their job training and extensively researched. Do you not know this? Were you not aware that MSE is an obscure procedure?

 

[MadTwatter]

.

I had septoplasty/turbinate reduction and it was probably the best money I ever spent. I haven’t had a cough or a cold in more than a year.

MSE is 2x more expensive, more painful, takes 10x longer, requires braces after but it arguably moves your maxilla 1mm forward.

 

[Deleted member 13710]

I had septoplasty/turbinate reduction and it was probably the best money I ever spent. I haven’t had a cough or a cold in more than a year.

Do you have any symptoms of empty nose syndrome at all? How long did recovery take?

I have been considering turbinate reduction for years now.

 

[MSEinvestigator]

It's a new procedure practiced by only a handful of professionals worldwide with very controversial results. It's not like bimax, which is a standard surgery for maxillofacial surgeons that is taught as part of their job training and extensively researched. Do you not know this? Were you not aware that MSE is an obscure procedure?

Well just because it’s obscure doesn’t mean that it’s a bad procedure. It guarantees an improvement in breathing without the risk of empty nose syndrome while also improving aesthetics if you have a narrow palate. What else can you ask for?

It also improves other parts of the airway not just the nose.

 

[Deleted member 13710]

It guarantees an improvement in breathing without the risk of empty nose syndrome

If you suffer from turbinate hypertrophy, a partial turbinectomy will do vastly more for your breathing than MSE. It's the difference between a direct and indirect solution to a problem.

while also improving aesthetics

People who have gotten MSE have complained about becoming less symmetric. That is the opposite of an improvement to aesthetics.

 

[Tallooksmaxxer]

Bimax?

 

[MSEinvestigator]

If you suffer from turbinate hypertrophy, a partial turbinectomy will do vastly more for your breathing than MSE. It's the difference between a direct and indirect solution to a problem.

You can only really shave off millimeters of tissue in specific areas. Widening the nasal walls gives you millimeters of more air space in the entire horizontal dimention. Even just theoretically it makes sense that the MSE would do more than a turbinate reduction in helping nasal congestion. Unfortunately there does not seem to be any studies measuring the actual airway improvements from septoplasty and turbinate reduction (and they have for MSE), so we cannot compare objectively. But the anecdotes seem to show that the MSE is more effective.

The only real argument for turbinate reduction is that they might keep growing to fill up the space that the MSE creates. But tbh that’s probably due to underlying allergies if that happens.

People who have gotten MSE have complained about becoming less symmetric. That is the opposite of an improvement to aesthetics.

That is true, but now with Dr. Lipkin’s Piezo, the MSE is basically a slam dunk now.

 

[MSEinvestigator]

If you suffer from turbinate hypertrophy, a partial turbinectomy will do vastly more for your breathing than MSE. It's the difference between a direct and indirect solution to a problem.


People who have gotten MSE have complained about becoming less symmetric. That is the opposite of an improvement to aesthetics.

I like to think of it like this: a huntergatherer with a 50mm IMW would never suffer from nasal congestion, even if he had a deviated septum or turbinate hypertrophy. There’s just a huge buffer there. Meanwhile with our tiny skulls our noses get congested just from a cold or allergies, and we need surgery to fix it. Why not just go back to the hunter gatherer standard?

 

[Deleted member 13710]

I like to think of it like this: a huntergatherer with a 50mm IMW would never suffer from nasal congestion,

This is broscience bullshit. "aLL hEaLtH pRoBlEmS cOmE fRoM tHe MoDeRn wOrLd" STFU. This is just a form of religious thinking.

Meanwhile with our tiny skulls our noses get congested just from a cold or allergies,

You have no way of knowing to what extent prehistoric people were affected by conditions like colds and other forms of congestion. You are completely making this up.

Why not just go back to the hunter gatherer standard?

You can't go back. MSE is just a clumsy way of cranking your face open in certain places hoping that your face expands in a healthy and harmonious way. It is primitive compared to something like bimax, which actually sets your bones in a healthier position and screws them in place, although partial relapse is a possibility. (Obviously bimax exists to solve other issues, I am just using it for the sake of comparison.)

 

[MSEinvestigator]

This is broscience bullshit. "aLL hEaLtH pRoBlEmS cOmE fRoM tHe MoDeRn wOrLd" STFU. This is just a form of religious thinking.

I’m not saying all health problems come from the modern world, but breathing problems and craniofacial dystrophy definitely do.

You have no way of knowing to what extent prehistoric people were affected by conditions like colds and other forms of congestion. You are completely making this up.

The fact that there was pretty much 0 malocclusion in pre agricultural homosapiens implies that they had good nasal breathing (because malocclusion comes from lack of Mewing basically which you can’t do if you’re mouth breathing), so that is a valid inference. Fine, I shouldn’t have said “would”. But I would bet my money that they didn't suffer from congestion issues to a significant degree.

You can't go back. MSE is just a clumsy way of cranking your face open in certain places hoping that your face expands in a healthy and harmonious way. It is primitive compared to something like bimax, which actually sets your bones in a healthier position and screws them in place, although partial relapse is a possibility. (Obviously bimax exists to solve other issues, I am just using it for the sake of comparison.)

Bimax is also pretty clumsy too though, you’re literally sawing your jaw off instead of moving the whole midface forward in a lefort 3 or MSE+facemask way. Still results in un ideal results. I agree the MSE is also un ideal relative to developing naturally. But I think if you can minimize asymmetry issues via an experienced provider + piezo like lipkin while using facemask to create 3d growth you can get pretty close.

 

[Deleted member 13710]

The fact that there was pretty much 0 malocclusion in pre agricultural homosapiens implies that they had good nasal breathing (because malocclusion comes from lack of Mewing basically which you can’t do if you’re mouth breathing),

You are conflating two different things: The size of the nasal cavity, which is skeletal, and issues like congestion, which have to do with inflammation of the tissues within. Having a wider nasal cavity does not mean that you don't experience inflammation of these tissues.

Bimax is also pretty clumsy too though, you’re literally sawing your jaw off instead of moving the whole midface forward in a lefort 3 or MSE+facemask way. Still results in un ideal results.

Both procedures seek to accomplish movements of bones, but bimax places bones exactly where they should be [as the surgeon has calculated], while MSE cranks the face wider at a certain part and hopes that the different parts of the skull widen in a healthy and harmonious way. It's direct vs. indirect movements.

But I think if you can minimize asymmetry issues via an experienced provider + piezo like lipkin while using facemask to create 3d growth you can get pretty close.

This is all speculation for obscure orthodontic techniques practiced by a minimal number of people on a minimal number of patients. If you want to try that, you are turning yourself into a guinea pig.

 

[MSEinvestigator]

You are conflating two different things: The size of the nasal cavity, which is skeletal, and issues like congestion, which have to do with inflammation of the tissues within. Having a wider nasal cavity does not mean that you don't experience inflammation of these tissues.

The thing is if you have a wide nasal cavity even if you have inflammation of the tissues it won’t even matter because your still be able to breathe through your nose. From an evolutionary perspective this makes total sense. If you think about your body’s immune response when getting sick (swelling of the turbinates and mucosal tissues, mucus production, etc), the whole point of that is to filter out foreign particles so that less of them gets into your lungs. But what ends up happening is that all the swelling and mucus means you can’t breathe through your nose, so you mouth breathe, completely undermining the whole point of the sinus immune response.

The question then arises: why is the body trying to make things worse for you? My theory is that the immune response is calibrated to the expectation that your nasal cavities are wide. Since everyone had wide nasal cavities during our evolutionary history, there was never a selection pressure to limit the level of inflammation to your ability to nasal breathe. It just assumed that you would be able to. This corroborates with the experiences of many people who have undergone MSE and felt that they could breathe perfectly fine even when sick.

This leans me toward believing that the root problem is actually the size of the nasal cavity as opposed to the inflammation within it.

Both procedures seek to accomplish movements of bones, but bimax places bones exactly where they should be [as the surgeon has calculated], while MSE cranks the face wider at a certain part and hopes that the different parts of the skull widen in a healthy and harmonious way. It's direct vs. indirect movements.

Sure, but if you believe lipkin’s success rate and minimal asymmetry results (which I tentatively do) , then I’d argue that MSE is moderately controlled, but granted yes less controlled than bimax. But what can you do? Expansion is expansion even if it’s not perfectly symmetrical or harmonious, it’ll still give breathing gains.

This is all speculation for obscure orthodontic techniques practiced by a minimal number of people on a minimal number of patients. If you want to try that, you are turning yourself into a guinea pig.

fair enough. The science always catches up to the broscience eventually, and I do think that the procedure makes sense and I’m willing to give it a try if it means no ENS and potentially curing my TMJD. I also think facemask works tbh, it seems like the people whom it doesn’t work for simply don’t wear it consistently enough. Also MSE is not THAT obscure. Lipkin has done over 500 cases himself. That’s a lot. SARPE has been around for decades, and MSE is just an improvement on it.

 

[Deleted member 13710]

The thing is if you have a wide nasal cavity even if you have inflammation of the tissues it won’t even matter because your still be able to breathe through your nose.

That is your assumption: That a tiny amount of expansion of the nasal cavity will completely alleviate inflammation. It's a multi-factor system, and you think that changing one variable, which is not even the variable directly causing the issue, will completely eliminate the problem. This is irrational thinking caused by a bias.

The question then arises: why is the body trying to make things worse for you? My theory is that the immune response is calibrated to the expectation that your nasal cavities are wide. Since everyone had wide nasal cavities during our evolutionary history, there was never a selection pressure to limit the level of inflammation to your ability to nasal breathe. It just assumed that you would be able to.

This the kind of "paleo thinking" that I was making fun of earlier. It is true that people in prehistoric times had better bone/skull development. It is not true that they were healthier overall. People in prehistoric times suffered enormous amounts of disease, and died of disease at rates unknown to modern populations. I don't think it's unreasonable at all to think that some of them had clogged noses for a few weeks/months at some points during their lives.

This corroborates with the experiences of many people who have undergone MSE and felt that they could breathe perfectly fine even when sick.

"the experiences of the many people" how many experiences have you actually learned about? I researched MSE about two years ago and could find less than 5 patients who shared their experiences online in any level of detail. Unless there has been a recent explosion in information about the topic, you probably haven't heard from "many people who have undergone MSE".

 

[MSEinvestigator]

That is your assumption: That a tiny amount of expansion of the nasal cavity will completely alleviate inflammation. It's a multi-factor system, and you think that changing one variable, which is not even the variable directly causing the issue, will completely eliminate the problem. This is irrational thinking caused by a bias.

Causation is a construct up to interpretation. If a nasal obstruction starts because of an inflammation of the turbinates from a cold or allergy reaction, you could see that the variable that changed is the inflammation. However that doesn’t not mean that it is what caused the obstruction for the sole reason that if the person had a larger nasal cavity wouldn’t have gotten obstruction regardless of a change in inflammation. The only reason inflammation appears to be the cause is because it is the more dynamic variable out of the two, whereas nasal cavity size is fixed after adulthood. Both can be interpreted as causes.

Like imagine someone with a 30mm IMW who every time they get any slight inflammation from allergies or food intolerance or stress they get completely blocked. Would you really suggest turbinate reduction to them? Or would realize that the variance in inflammation is only symptomatic under the condition of a narrow nasal cavity. (The normal IMW for adult is 38-42mm) On the other hand, if someone has a 45mm IMW and somehow still gets nasal obstruction, like if they got smashed in the nose and had a massively deviated septum while also having allergies at the same time, then yeah, I’d say go for the ENT surgeries. You have to consider both bottle necks. I just think right now the medical field is biased toward only considering the ENT bottle neck, while also the average of the population having an already narrower nasal cavity than evolutionary ideal. Thus considering both these biases, we should ideally see the average treatment protocol to lean more toward an expansionary treatment over ENT surgery.

This the kind of "paleo thinking" that I was making fun of earlier. It is true that people in prehistoric times had better bone/skull development. It is not true that they were healthier overall. People in prehistoric times suffered enormous amounts of disease, and died of disease at rates unknown to modern populations. I don't think it's unreasonable at all to think that some of them had clogged noses for a few weeks/months at some points during their lives.

Again you keep strawmanning me. I totally agree that modern civilization has created much more good than harm in terms of our health compared to paleo. However there are SOME aspects of modernity that has regressed us, such as craniofacial development. Maybe the paleo man had obstructions some times, but it was probably never chronic, as if it was we would have seen malocclusion.

"the experiences of the many people" how many experiences have you actually learned about? I researched MSE about two years ago and could find less than 5 patients who shared their experiences online in any level of detail. Unless there has been a recent explosion in information about the topic, you probably haven't heard from "many people who have undergone MSE".

I’ll give you an example. I spoke with my current MSE provider who said that based on her experiences working in the field with other professionals and talking to others who had it (she herself had it too), almost everyone she talked to has had a significant improvement to breathing. Whereas her experiences talking to people who have done ENT surgery, they have noted that sometimes the improvements went away after a few years (turbinates regrowing) or they simply didn’t notice much improvement at all. The impression I got was that MSE gave more consistent gains.

 

[Deleted member 13710]

Like imagine someone with a 30mm IMW who every time they get any slight inflammation from allergies or food intolerance or stress they get completely blocked. Would you really suggest turbinate reduction to them?

Yes, if they are dealing with inflammation problems, I would recommend the surgery that directly deals with inflammation, rather than an experimental orthodontic procedure that is likely going to make their whole face permanently lopsided with potentially no breathing benefit whatsoever. That is some mad scientist shit.

However there are SOME aspects of modernity that has regressed us, such as craniofacial development.

Which I acknowledged.

Maybe the paleo man had obstructions some times, but it was probably never chronic,

You have no strong basis for saying this. You are taking one factor and assuming it's the only relevant factor. There are so many other variables we haven't even mentioned. We don't know, for instance, if there is more potential for inflammation in a larger nasal cavity (more tissues to get inflamed within that limited space), for instance. If that's the case, the potential for congestion might actually be identical between a smaller and a larger nasal cavity. An ENT specialist might be able to answer that, or even he/she might need to speculate. We also don't know if the disease variants that existed in prehistory triggered stronger respiratory responses. There is no way of saying that "[inflammation in prehistory] was probably never chronic". That is wild speculation.

I’ll give you an example. I spoke with my current MSE provider who said that based on her experiences working in the field with other professionals and talking to others who had it (she herself had it too), almost everyone she talked to has had a significant improvement to breathing.

"Why yes, the procedure I offer is brilliant, in fact. What was your credit card number, again?"

Whereas her experiences talking to people who have done ENT surgery, they have noted that sometimes the improvements went away after a few years (turbinates regrowing) or they simply didn’t notice much improvement at all.

There is a new, somewhat experimental turbinate reduction procedure that uses radio frequency treatments to reduce the size of the turbinates without actually cutting them. It is less dangerous, but results seem to be temporary (it is such a new procedure that long term results are still somewhat speculative). The standard turbinate reduction procedure (cutting the turbinates) has permanent results.

 

[MSEinvestigator]

Yes, if they are dealing with inflammation problems, I would recommend the surgery that directly deals with inflammation, rather than an experimental orthodontic procedure that is likely going to make their whole face permanently lopsided with potentially no breathing benefit whatsoever. That is some mad scientist shit.

Ok this is a very low IQ position lol. Because everyone deals with inflammation, it’s just most people are wide enough to not have symptoms. My protocol is determine what is the bottle neck and treat to that. Then let me give you another hypothetical. What if the person has a 20mm IMW? Where would you draw the line for finally doing something about the maxilla?

Which I acknowledged.


You have no strong basis for saying this. You are taking one factor and assuming it's the only relevant factor. There are so many other variables we haven't even mentioned. We don't know, for instance, if there is more potential for inflammation in a larger nasal cavity (more tissues to get inflamed within that limited space), for instance. If that's the case, the potential for congestion might actually be identical between a smaller and a larger nasal cavity. An ENT specialist might be able to answer that, or even he/she might need to speculate. We also don't know if the disease variants that existed in prehistory triggered stronger respiratory responses. There is no way of saying that "[inflammation in prehistory] was probably never chronic". That is wild speculation.

Dude I’m not saying that inflammation was never chronic, I’m saying that even if it was, the effect on nasal breathing would not be as significant as modern humans. And your position that maybe the tissues would swell to fill up larger cavity makes somewhat sense, but a larger nasal cavity 100% correlates to more tolerance to nasal obstruction, even if the inflammation does catch up to SOME extent. Also how is it speculative to say that they didn’t have chronic nasal obstruction issues? Chronic Nasal obstruction = chronic mouth breathing = malocclusion. But we found: no malocclusion = no chronic mouth breathing = no Chronic nasal obstruction. Even if we can’t directly look at their nasal breathing, we can infer.

I feel like you are basically harping on me for being to speculative about my positions. But I believe spectulation is rational because our evaluations of truth are based on probabilistic thinking, and if you deny that you’re delusional. I’m a Bayesian.

"Why yes, the procedure I offer is brilliant, in fact. What was your credit card number, again?"

Thing is at the end of the consult she actually told me she wouldn’t feel comfortable treating me due to me having to move later this year. She told me to find lipkin. So checkmate, there’s no conflict of interest.

There is a new, somewhat experimental turbinate reduction procedure that uses radio frequency treatments to reduce the size of the turbinates without actually cutting them. It is less dangerous, but results seem to be temporary (it is such a new procedure that long term results are still somewhat speculative). The standard turbinate reduction procedure (cutting the turbinates) has permanent results.

That’s good to know. Seems like both sides are improving the techniques. MSE is improving and so is turbinate reduction. Good news.

 

[kramer]

@Chinlet Ascension

youre fucking brain dead thinking turbinate reduction > MSE

I gaurentee you havent gotten either of them

 

[Deleted member 13710]

@Chinlet Ascension

youre fucking brain dead thinking turbinate reduction > MSE

I gaurentee you havent gotten either of them

Genius comment. You are so observant it's incredible!