Uvulopalatopharyngoplasty (UPPP) is a surgery to open the upper airway by removing excess tissue from the throat. It can be used to treat mild obstructive sleep apnea (OSA) or severe snoring.
UPPP removes soft tissue from the back of the throat. This includes:
- All or part of the uvula (the flap of soft tissue that hangs at the back of the mouth).
- The part of the soft palate and tissue on the sides of the throat.
- Tonsils and adenoids, if they are still there.
Why?
Your doctor may recommend this surgery if you have mild obstructive sleep apnea (OSA).
Start by trying lifestyle changes, such as losing weight or changing your sleeping position.
Most experts recommend trying CPAP, nasal strips, or an oral device to treat OSA first.
Even if you don't have OSA, your doctor may recommend this surgery to treat severe snoring. Before you decide to have this surgery:
See if losing weight helps with snoring.
Consider how important it is for you to treat your snoring. Surgery is not suitable for everyone.
Make sure your insurance covers the cost of this surgery. If you also don't have OSA, your insurance may not cover surgery.
Sometimes, UPPP is performed along with other more invasive procedures to treat more severe forms of OSA.
risk
General risks of anesthesia and surgery are:
Reaction to medications or breathing problems Bleeding, blood clots, or infection The risks of this surgery are:
- The muscles of the throat and soft palate are damaged. When drinking alcohol, you may experience some obstruction of the flow of fluid from your nose (called velopharyngeal insufficiency). In most cases, this is only a temporary side effect.
- Mucus in throat.
- Speech changes.
- Dehydration.
Before surgery
Be sure to tell your doctor or nurse:
If you are pregnant or may become pregnant Medications you are taking, including medications, supplements, or herbal remedies you purchased without a prescription If you have been drinking a lot, more than 1 to 2 drinks per day A few days before surgery:
You may be asked to stop taking blood thinners such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
Ask your doctor what medications you should still take on the day of surgery.
If you smoke, try to stop. Smoking slows healing. Ask your provider for help quitting smoking.
Let your provider know about any colds, flu, fevers, herpes outbreaks, or other illnesses you may have before surgery. If you do get sick, your surgery may need to be postponed.
On the day of surgery:
You may be asked not to drink or eat anything for a few hours before surgery.
Take any medications your doctor tells you and drink a sip of water.
Follow the instructions on when to arrive at the hospital. Please arrive on time.
after surgery
After surgery, you will be taken to a room to wake up from the anesthesia. At first, your throat will feel sore. Speaking and swallowing can be difficult. You may also feel drowsy and nauseous.
This surgery usually requires an overnight stay in the hospital to make sure you can swallow. UPPP surgery can be painful, and full recovery takes 2 or 3 weeks.
Your throat will be very sore for several weeks. You will be given liquid pain medication to relieve soreness.
You may have stitches in the back of your throat. These will dissolve or your doctor will remove them at the first follow-up visit.
Eat only soft foods and liquids for the first 2 weeks after surgery. Avoid crunchy foods or foods that are difficult to chew.
For the first 7 to 10 days, you will need to rinse your mouth with salt water after meals.
Avoid heavy lifting or exertion for the first 2 weeks. After 24 hours, you can walk and do light activities.
You will have a follow-up visit with your doctor 2 or 3 weeks after surgery.
Outlook (prognosis)
About half of people who have this surgery experience an initial improvement in their sleep apnea. Over time, for many people, this benefit wears off. Some studies suggest that surgery is best for people with soft palate abnormalities.
