Case Summary
The patient came to our clinic with the main concerns of poor sleep, frequent awakenings at night, daytime tiredness, mood changes, and frequent nasal congestion.
In sleep-related breathing problems, both anatomical (physical structures) and non-anatomical (functional or regulatory) factors can contribute to symptoms. In this case, anatomical features played a major role. The patient showed clear improvement almost immediately after increasing jaw size, which helped to open the airway.
At the start, the patient’s upper airway was larger than average, but this came at the cost of abnormal neck curvature and head posture. This over-compensation was reflected in the airway shape, which had an exaggerated “S-curve.”
Treatment and Outcomes
The patient underwent a 3D-guided midpalatal piezocorticotomy combined with MARPE (Micro-Implant Assisted Rapid Palatal Expansion) over a period of 9 weeks. After treatment, the patient experienced:
- Noticeable improvement in all baseline symptoms
- Easier nasal breathing
- Deeper, higher-quality sleep
The midpalatal suture expanded evenly and in parallel, with an average separation of 8.1 mm. Overall, the upper airway volume increased by 18%, and the narrowest cross-section expanded by 33%.
Next Steps
The next phase of the MARPEFACE protocol will focus on mandibular (lower jaw) expansion to further improve the relationship between the upper and lower jaws, with the goal of achieving even better airway function and symptom relief.
