UPPP for Palatal Prolapse?

[cpap90000]

Has anyone UPPP surgery for palatal prolapse?
I suspect i have palatal prolapse as Nasal stents unblocked the palate/ nose so i could nose exhale again but it was not sufficient.
My soft palate is no longer visible, hanging below my tongue and when i swallow i can feel it like a flap of skin. Can UPPP surgery cut this loose soft palate area and make the throat area bigger?

[super7pilot]

I had UPPP over 20 years ago. They didn't say it was for prolapse. In those days. I didn't fit the norm of an apnea patient. I was was young, fit and not fat.

But the Dr's did see that the base of my tongue, tonsils and uvula were unusually large. So I had a naturally small airway as a result. So I was told that I was a candidate for UPPP. And in my case it actually worked (for 22 years) then I started to have apnea again. But not obstructive apnea's. For me it was 103 Hypopnea's during my lab sleep. Only had 3 obstructive and 2 central apnea's in 6 hrs.

But UPPP surgery is VERY, VERY painful to recover from. And the surgeon warned me of this. I had my tonsils and uvula removed. They could have gone in again and kerfed the base of my tongue to reduce it's size. But I said no way Jose'.

With the new interstate highway going down your neck, You WILL be far more prone to choking on food and drinks. I have had several close calls where I was alone and choked on food to the point I was looking for something to do a self Heimlich.

My current ENT said it's not a procedure that is done very often as it is seen as rather barbaric and like me the apnea will normally return over time.

[bloom25]

I'd be cautious about getting UPPP done -- make sure to really do your research. That procedure often doesn't improve things much, and even seems to cause problems for certain people.

[cpap90000]

Thank for your answer.
They say UPPP can work for floppy palate issues but I need to find a experienced surgeon like you said. Did it effect swallowing or any problem with eating, any damage to muscles in the throat? I will go slowly and have uvula removal and tonsillectomy firstly. Then if its still a issue, a form of UPPP surgery. Thanks

[bloom25]

Thank for your answer.
They say UPPP can work for floppy palate issues but I need to find a experienced surgeon like you said. Did it effect swallowing or any problem with eating, any damage to muscles in the throat? I will go slowly and have uvula removal and tonsillectomy firstly. Then if its still a issue, a form of UPPP surgery. Thanks

I'd check out Dr Steven Park's interview with Dr Christian Guilleminault (who was a pioneer in sleep-related breathing disorders). Here's a link to it: https://breathesleepfeelbetter.libsyn.co...lt-on-uars

At around the 48 min mark, he talks about UPPP.

[super7pilot]

Yes UPPP did affect my eating in that I was far more prone to choking after my surgery. And it continues to this day.

[cpap90000]

thanks for letting me know

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yes hes against the procedure. i will get the tonsils and uvula removed. ENT said this would ok. if its still problematic, UPPP.

[bloom25]

You might also consider asking your ENT about how UPPP could affect CPAP efficacy. In some (not all) patients, it can make CPAP less effective. It’s just something worth bringing up with your doctor in case you end up going down that path.

I mention it because I had upper airway surgery myself (a tonsillectomy and modified UPPP) a couple of years ago in hopes of getting off CPAP. Unfortunately, it didn’t improve my symptoms — and now, CPAP no longer provides relief either. I can’t say for sure that UPPP was the cause, but I did speak with a doctor who mentioned that this outcome can happen in a subset of patients. Just sharing so you have more context to make an informed decision.

[cpap90000]

yes the ENT warned me that it might effect cpap. But i am literally choking on my uvula and palate is just so down my throat, the palate is effecting my breathing. back of my throat is no longer visible. I would hope UPPP would cut this excess tissue away and make it easier to breathe. i am considering going to A+E its that bad.

[super7pilot]

I can tell you MY experience 22 yrs after my UPPP my Dr. asked me to go in for a sleep study. Not because I was falling asleep during the day. But because I was on three different meds for blood Pressure. She said that indicates sleep apnea. So I did the in lab study in which which I slept for 6 hrs.
I had 2 Centrals .33AHI
I had 3 Obstructive .5AHI
I had 103 Hypopnea's 17.61AHI
My total AHI was 22

After being put on pap therapy in October 9 of 2024. My AHI dropped from 22 in my sleep study to .77 average for the last 9 months since starting pap therapy. I have dropped one of my BP meds and have the same to lower BP that I had taking three BP meds. I call that a success.

Part of my issue back then was that for the 2 yrs I was on cpap before the UPPP. It was tough as the humidifiers of the day were a pan of cold water. There was no EPR for exhale pressure relief. BiPap was a new thing and wasn't auto adjusting and they were BIG, BIG money because Resperonics had a patent on BiPap starting in 1992 and insurance was highly resistant to handing them out. So after 2 yrs of cpap and MANY bloody noses later. (I lived in the very dry cold desert of South Dakota) I jumped at the chance for the UPPP. If they had the machines of today back then. No way would I do UPPP. BUT to be sure. That's just me and my opinion about me and my situation. You and your situation might be much different.