Surgery Overview
Uvulopalatopharyngoplasty (UPPP) is a procedure that removes excess
tissue in the throat to make the airway wider. This sometimes can allow air to
move through the throat more easily when you breathe, reducing the severity of
obstructive
sleep apnea (OSA). The tissues that are removed may
include:
- The soft finger-shaped tissue that hangs down from
the back of the roof of the mouth into the throat (uvula).
- Part of the roof of the mouth
(soft palate).
- Excess throat tissue,
tonsils, and adenoids.
See pictures of the
tonsils, adenoids, and uvula and the
hard and soft palates.
If an enlarged tongue is a factor in your sleep apnea, the surgeon
may remove a small part of the tongue. This is called an
uvulopalatopharyngoglossoplasty.
What To Expect After Surgery
You may need
continuous positive airway pressure therapy (CPAP)
therapy after surgery. CPAP therapy uses a breathing device that you wear at
night that helps you breathe more easily and prevents your airway from closing
during sleep.
Some pain medicines can relax the throat muscles. You may have to
avoid these medicines after surgery to make it less likely that your airways
will narrow and cause apnea episodes.
Why It Is Done
Your doctor may suggest UPPP if you:
- Have excess tissue in your nose, mouth, or
throat that blocks your airway.
- Choose not to use (or cannot use)
CPAP.
- Do not get better after using CPAP.
- Do not want
to have an opening made in your windpipe (tracheostomy) to treat sleep
apnea.
Children usually do not have UPPP. For them, removing the tonsils
and adenoids usually cures sleep apnea.
How Well It Works
UPPP may reduce sleep apnea in some people, but results are mixed.1, 2
UPPP may stop snoring, but apnea episodes may continue.3
Even if surgery successfully removes the blockage, you may still
need CPAP after surgery.
Risks
Complications during surgery include accidental damage to
surrounding blood vessels or tissues.
Complications after surgery may include:
- Problems swallowing.
- Speech
problems. The surgery may result in a nasal quality to the
voice.
- Changes in how food tastes.
- Swelling, pain, infection, or bleeding.
- Narrowing of the airway in the nose and throat.
- Sleepiness and periods of not breathing (apnea)
related to the medicines that are used to relieve pain and help you
sleep.
What To Think About
Before considering surgery, you should try CPAP.
You will need a
sleep study after UPPP surgery to find out if your
sleep apnea has improved. If you still stop breathing at night, you may still
need CPAP.
Laser-assisted uvulopalatoplasty is sometimes used to
treat mild to moderate obstructive sleep apnea, although not all people
benefit. This procedure is not recommended by the American Academy of Sleep
Medicine to treat sleep apnea.4, 5
People who are
obese or who have some other illnesses are more likely
to have complications after UPPP.6
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Sundaram S, et al. (2005).
Surgery for obstructive sleep apnoea in adults.
Cochrane Database of Systematic Reviews (4).
- Caples SM, et al. (2010). Surgical modifications of the upper airway for obstructive sleep apnea in adults: A systematic review and meta-analysis. Sleep, 33(10): 1396–1407.
- Malhotra A, White DP (2002). Obstructive sleep apnea.
Lancet, 360(9328): 237–245.
- Aurora RN, et al. (2010). Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep, 33(10): 1408–1413.
- Littner M, et al. (2001). Practice parameters for the
use of laser-assisted uvulopalatoplasty: An update for 2000. Sleep, 24(5): 603–619.
- Kezirian EJ, et al. (2006). Risk factors for serious
complication after uvulopalatopharyngoplasty. Archives of Otolaryngology—Head and Neck Surgery, 132(10): 1091–1098.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Mark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine |
|---|
| Last Revised | June 17, 2011 |
|---|
Last Revised:
June 17, 2011
Sundaram S, et al. (2005).
Surgery for obstructive sleep apnoea in adults.
Cochrane Database of Systematic Reviews (4).
Caples SM, et al. (2010). Surgical modifications of the upper airway for obstructive sleep apnea in adults: A systematic review and meta-analysis. Sleep, 33(10): 1396–1407.
Malhotra A, White DP (2002). Obstructive sleep apnea.
Lancet, 360(9328): 237–245.
Aurora RN, et al. (2010). Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep, 33(10): 1408–1413.
Littner M, et al. (2001). Practice parameters for the
use of laser-assisted uvulopalatoplasty: An update for 2000. Sleep, 24(5): 603–619.
Kezirian EJ, et al. (2006). Risk factors for serious
complication after uvulopalatopharyngoplasty. Archives of Otolaryngology—Head and Neck Surgery, 132(10): 1091–1098.