u/NovaNoble

I’ve had breathing problems basically my entire life, largely due to allergies. My tonsils were removed at a very young age because they were always inflamed. I was eventually diagnosed with allergic rhinitis and hypertrophic turbinates. Medications never gave me lasting relief. Some would actually backfire after prolonged use and leave my nasal passages feeling completely closed.

My first surgery was a septoplasty with turbinate reduction. It didn’t really help much.

For my second surgery, I went to a different ENT who performed a partial turbinectomy, radiofrequency reduction, and turbinate outfracture. I was awake under local anesthesia.

I will never forget walking out of that procedure. During the radiofrequency treatment I could literally smell the smoke, but at the same time I could feel so much air moving through my nose. I remember thinking, “Is this what regular people feel like?” I was ecstatic. I prayed it would last forever.

It didn’t.

Eventually I went back to the same doctor. We decided to be more aggressive with another partial turbinectomy and radiofrequency reduction. We didn’t repeat the outfracture because that had already been done.

Again, I had the procedure awake under local anesthesia. Again, it worked initially. And again, I eventually returned to baseline.

At that point I genuinely started wondering whether I was going to need turbinate surgery every year just to breathe.
My doctor was surprised when I scheduled another appointment. When he looked inside my nose, he seemed even more surprised by how everything had healed and how obstructed I felt again. He referred me to a colleague whom he described as a “specialist.”

From my first conversation with this doctor, I didn’t like the direction things were going.

He recommended essentially the same turbinate procedures again, except this time under general anesthesia, and strongly pushed another septoplasty for “maximum results.”

I told him I had already had a septoplasty and did not want another one. He looked shocked and eventually told me that the first surgeon hadn’t done a good job because the posterior portion of my septum was still deviated.

What has always stood out to me is that at the beginning of these ENT consultations, they spray a decongestant into my nose. When they do that, I can breathe normally. To me, that has always been a pretty significant clue that inflammation and allergies are a major part of this.

When I discussed actually treating the allergies, I was told I could come in for weekly allergy shots that they would have to administer themselves. That would mean physically going to their office every week of the year, which is basically impossible for someone who actually has a job. (They don’t work Saturdays or Sundays either.) And after all of that, they told me I could STILL eventually revert right back to baseline!

So I’m supposed to rearrange my work schedule every single week, potentially for years, only to be told there’s still a possibility I end up exactly where I started.
So instead, I have repeatedly ended up being offered another procedure.

What has also bothered me is that through all of these consultations and procedures, nobody ever discussed my high vaulted palate and narrow maxilla or whether my skeletal anatomy could be contributing to the limited size of my nasal airway.

I’m now seriously researching palatal expansion, MARPE/MASPE, double jaw surgery & SAAT for my allergy issues, potentially combining allergy treatment with palatal expansion so I can address both the inflammatory and anatomical sides of the problem.

I have even considered a full turbinectomy out of desperation, although the potential consequences of permanently removing too much turbinate tissue obviously concern me.

The entire experience has severely damaged my trust in the medical industry. I’ve spent tens of thousands of dollars and gone through four procedures, yet I’m essentially back at baseline.

My experience has left me feeling that, for many people, the medical industry has become a way for doctors and the larger system to extract money and resources from patients. There are procedures and treatments used in Europe, Latin America, and Asia that can take years to become available or accepted here because of the bureaucracy surrounding medicine. Meanwhile, extremely powerful and potentially addictive medications for things like depression and weight loss seem to have no problem becoming enormous industries.

I also think many doctors become extremely comfortable operating inside the framework they were trained in. When something falls outside of that framework, it can be dismissed surprisingly quickly. The relationship between the width of the maxilla, the dimensions of the nasal cavity, and nasal breathing seems logical enough to at least investigate, yet not one of the ENTs who treated me ever brought up my narrow, high vaulted maxilla.

I’m not claiming SAAT or palatal expansion is definitely the answer. I don’t know yet. But after four procedures and thousands of dollars only to end up back where I started, I’m done blindly repeating the same approach and expecting a different outcome.

Has anyone here dealt with a similar experiences? Has anyone tried SAAT, MARPE/MASPE, another form of palatal expansion, or some combination of allergy treatment and skeletal expansion and actually experienced lasting improvement in nasal breathing?