Sleep Apnea Surgery Center

Nasomaxillary Expansion overview

The TPD/EASE procedure was developed by Dr. Li in 2017.  The objective of the operation was to maximize the nasal airway expansion while minimizing the undesired side effects.  The operation focuses on the entire nasomaxillary complex, including the posterior region of the maxilla without excessive widening of the dentoalveolar aspect.

Nasal expansion directly improves nasal respiration, and the reduction of nasal resistance leads to lower airway velocity and reduced negative nasal pressure on inspiration, with subsequent impact on the rest of the airway.

EASE/TPD Treatment Course:

Preoperative requirement:

  • CT scan
  • Covid Test 48 hours prior to surgery

Intraoperative course:

  • Surgery takes approximately 30 minutes (TPD) and 60 min (EASE) under IV sedation
  • Discharge within 30–45 minutes after surgery

Postoperative management:

  • Pain control consists of Ibuprofen (such as Advil) 200–400 mg every six hours
  • Tylenol 325 mg in-between the doses of Ibuprofen
  • For EASE patients, Hydrocodone can be taken instead of Tylenol if necessary
  • Pain medication is typically needed for a few days
  • No restriction in physical activity after 3 days
  • Diet of soft food such as well-cooked pasta, fish, milk shakes and soup

Expansion course:

  • Duration can range between 6-8 weeks or even longer for EASE patients
  • Expansion starts within 2–4 days of the operation and is typically 2–3 times per week
  • Usually no pain during the expansion but some pressure may be felt
  • Twice weekly communication with Dr. Li after returning home is necessary to monitor the expansion progress (for out-of-town patients)
  • There is no major dietary restriction during the expansion phase other than avoiding big and chewy food such as bagels, Dutch crunch bread, etc.

Consolidation phase:

  • Orthodontics can begin during the consolidation phase
  • The device needs to remain for 8–12 weeks after the completion of the expansion
  • Removal is performed under local anesthesia at Sleep Apnea Surgery Center





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