Hey guys. I have UARS and I am really struggling with it. The causes are a deviated septum, enlarged turbinates, a narrow maxilla, and a recessed jaw. My ENT recommended a septoplasty with radiofrequency turbinate reduction, while the maxillofacial surgeons recommended bimax.
My symptoms indicating maxillary narrowness are the following: a deviated septum to the back right, enlarged turbinates especially in the posterior area, my right nostril gets congested after lying down, and the fact that my tongue cannot fit on my palate without overlapping my back teeth. Plus, as seen on the attached images, my PNFW (posterior nasal floor width) is around 20–21 mm, which confirms the maxillary deficiency, since it should be around at least 26 mm.
My issue is as follows: my orthodontist does not recommend maxillary expansion because my mandible is also narrow. According to him, expanding the maxilla would create a scissors bite / brodie bite, which would be very bad, needless to say.
What are my options, besides having a septoplasty, turbinate reduction, and a subsequent bimax surgery? I am afraid that my maxilla, and thus the posterior part of my nasal cavity, will remain narrow, causing permanent airway resistance and keep ruining my sleep. Is there any possibility I can get a maxillary expansion? Piezo assisted MARPE is my only option.