transpalatal advancement pharyngoplasty (TAP) experience?

[ihabiqbal99]

Hi Everyone.

I am a longtime lurker and first time contributor to this forum. I wanted to find out whether anyone here has had transpalatal advancement pharyngoplasty (TAP) done and how that experience was.

I was diagnosed with sleep apnea 3 years ago. I first had a septoplasty and turbinate reduction in 2014, followed by a modified UPPP (soft palate reduction, partial epiglottectomy and lingual tonsil removal) in late 2015. I am currently using the cpap. My most recent sleep study in Feb 2016 indicated a Supine AHI in the 60s and a non-supine AHI under 10. However, positional therapy (using a sleep bumper) does not seem to solve the problem. I still wake up tired and have a lot of other symptoms associated with sleep apnea. My ENT surgeon is saying it is because my soft palate continues to fall back when I sleep and this is causing the obstruction, hence the need for the TAP which would take out a small portion of my hard palate and pull the soft palate forward making it more rigid and leaving more space in the airway when I sleep.

Appreciate any responses. Thanks

[grayghost4]

Supine AHI in the 60s

Is that with Cpap ?

you might post a night of Sleepyhead and you might get some help

[ChicagoGranny]

I still wake up tired and have a lot of other symptoms associated with sleep apnea.

Have you optimized your CPAP therapy using SleepyHead software? There are many things you can do, short of another surgery, to eliminate symptoms and become energetic.

it is because my soft palate continues to fall back when I sleep

You do realize this is the most common cause, along with the tongue falling back, of obstructive sleep apnea?

[Sheffey]

I first had a septoplasty and turbinate reduction in 2014

followed by a modified UPPP (soft palate reduction, partial epiglottectomy and lingual tonsil removal) in late 2015

the TAP which would take out a small portion of my hard palate and pull the soft palate forward

Wow! Sounds like a scalpel-happy surgeon.

[Goofproof]

No wonder you can't breath, that's a mouthfull. Jim

[grayghost4]

do you think the term "guineapig" applies

[DWaldman]

Just keep cutting away, eventually your surgeon will recommend a tracheotomy to let the air in... or you could cut to the chase, so to speak, and let him just punch that hole in your neck now.

[Guest]

A lot of people here think me or my surgeon are trigger happy. Couldnt be further from the truth.

My nasal surgery was a no-brainer. I had sinus problems all my life growing up. One of my nostrils was completely blocked off. So I go that taken care of first with a turbinectomy and septoplasty.

As for the UPPP, I know jury is still out on it, but I went in after doing extensive research, talking to multiple doctors and fully aware of the chances of success. Given that I had a AHI of 40s non-supine and 60s supine (without cpap), I dont think its unreasonable to try to lower the severity of sleep apnea through surgical intervention so that on the nights that I am unable or unwilling to wear the cpap, I am not a complete wreck the next day. The results of the UPPP were mixed. The non-supine AHI dropped to single digits but the supine AHI remained around the same.

Which brings me to my current situation. I continue to use the cpap but despite my best efforts I cannot seem to average more than 3.6 hours a night. Given the low non-supine AHI, positional therapy should work but in my case it has not. Which brings me to looking at other surgical and non-surgical options. These are MMA, TAP (transpalatal advancement pharyngoplasty) or a dental appliance.

I have decided to continue trying to get my hours up with the CPAP, but if anyone here has any knowledge or experience with the the other options or has any helpful advice, it would be appreciated.

[ChicagoGranny]

I have decided to continue trying to get my hours up with the CPAP

What's your plan to achieve this?

- Do you plan to register in the forum?
- Will you fill out your equipment profile? https://www.cpaptalk.com/ucp.php?i=prof ... pment_info
- Will you use SleepyHead software to optimize your CPAP therapy? https://sleep.tnet.com/resources/sleepyhead
- Will you seek advice from the forum to achieve your goals with CPAP?

That's how most people who come here achieve their goals.