What is Uvulopalatopharyngoplasty?

Have you ever dreamed you were in a spelling bee back in school? Everybody but you and one other individual is out of the competition. And then… the judges give you your word: uvulopalatopharyngoplasty. And no amount of practice could have prepared you for this one. That’s one tough word to spell (even for an amazing, non-dreaming speller).

That’s not a fake word, believe it or not. It’s a genuine word. Turns out, uvulopalatopharyngoplasty (called UPPP for short, mercifully) is a surgical procedure designed to help treat obstructive sleep apnea.

Generally, this surgical procedure is applied when other, more conservative approaches haven’t really helped or produced the desired effects. For those individuals, UPPP can offer a practical way to reduce your obstructive sleep apnea symptoms and help you get a restful night’s rest.

What is Uvulopalatopharyngoplasty?

There are a large number of causes for sleep apnea. But for many individuals, this sleep disorder is a result of your body’s own tissues. These tissues can obstruct your airways when they start to loosen up and droop. As a consequence of this obstruction, you start snoring, and you stop breathing. In this way, sleep apnea can disrupt your normal sleep cycle.

This means you can feel tired all the time, wake up often (or with headaches), and be just generally miserable. Respiratory conditions, like sleep apnea, should be taken very seriously because they can even result in death in rare cases.

During a UPPP surgery, your surgeon will remove a substantial portion of tissue from your throat. The idea is that eliminating this excess tissue will also get rid of the obstruction from your airway. For a specific group of people with sleep apnea this surgery, which was developed in 1981, has become an ever more effective form of treatment.

Is UPPP right for you?

UPPP isn’t right for everybody or for all sorts of breathing conditions. As a matter of fact, to be a good candidate for UPPP, it’s important for you to have the right kind of sleep apnea. Further, only people with Stage 1 obstructive sleep apnea will likely be helped by this surgery.

We may want to make sure that you’ve exhausted all other treatment solutions. In General, UPPP might be right for you if:

• You have attempted to manage your sleep apnea by losing weight or lowering your BMI, but this hasn’t achieved the desired results.
• Your doctor has diagnosed you with Stage 1 obstructive sleep apnea. This procedure isn’t right for individuals with stage two or three sleep apnea.
• Your symptoms are not alleviated by any other treatment solutions. This could include a CPAP machine or other treatments also.
• You have obstructive sleep apnea, and this sleep apnea has a negative impact on your general quality of life.
• Your sleep apnea is caused at least in part by structural issues around your airways, especially in regards to your soft palate and your tonsils.

If you have a sleep-associated breathing disorder, it’s important to get the right treatment. We will be able to assess your symptoms and give you a diagnosis. Then we will develop a treatment plan distinct to your situation.

What occurs during a UPPP procedure?

Typically, general anesthesia is utilized for a UPPP surgery. Which parts of your airways are creating the biggest problem will be established by your surgeon just prior to the surgery. Why you have so much extra tissue in your throat is something we will need to determine. Every person is a little bit different in this respect.

During a UPPP surgery, your surgeon will clear away tissue from the following areas:

• The ball of tissue hanging down at the back of the mouth, called the uvula.
• The soft palate that forms the roof of your mouth near the back of your mouth.
• Your tongue might also need to have some tissue eliminated. It’s actually a different surgery, when you have tissue eliminated from your tongue, called uvulopalatopharyngoglossoplasty (which is also a real tongue twister, uh, no pun intended). If you’re a good candidate for this surgery, it’s something your surgeon will discuss with you well in advance.
• Around the throat, any excess tissue. If you still have tonsils and adenoids, this could include them.

Once the tissue is extracted, your surgeon will seal the incisions with sutures. Sometimes, you may require an overnight stay in a hospital but generally, your UPPP surgery will be done on an outpatient basis. Your local healthcare setting, your general health, and your surgeon are all factors here. Your surgeon will want to be certain you’re able to swallow normally before you go home.

Preparing for your UPPP procedure

Just like any surgical procedure, you may need to take numerous steps to get ready for your UPPP appointment. You won’t have any surprises because you and your surgeon will talk about everything well in advance.

Here are some preoperative instructions you may get:

• Your doctor will provide you with a complete list of what to avoid using and what to keep taking.
• You will be informed to alert your surgeon about any illnesses you may have, including a cold. This may delay your procedure.
• Some over-the-counter medications, especially painkillers like aspirin and ibuprofen, will thin your blood and should be avoided before surgery unless approved by your surgeon.
• You will also need someone to drive you home from the procedure, especially if you are undergoing your UPPP surgery on an outpatient basis.
• There may be a short period before surgery that you need to fast.
• You may be asked to take certain medications on the day of your surgery.

As you get ready for surgery, be certain to ask your surgeon any questions that they haven’t already answered during this process.

Recovery and post-operative care

The duration of your recovery from UPPP surgery will vary, depending on how much tissue has been extracted by your surgeon. Generally speaking, however, you can expect at least 2-4 weeks of recovery time.

You should try not to be too idle, but you should also abstain from overly rigorous activity for a couple of weeks. In other words, you want to keep moving and walking about, as this will help prevent blood clots from developing.

For the first 1-3 weeks, most patients will:

• Have a sore throat. This sore throat may continue for several weeks after your procedure.
• Eat only soft foods. Immediately after your surgery, you will be restricted to clear liquids, but when you feel ready you’ll be able to move up to soft foods. You’ll likely stick with soft foods until we give you the thumbs up to move ahead.
• Avoid infection by using a salt-water-based mouthwash.

If you have any questions about your recovery and what to expect during the healing process, make certain to ask us. In about 2-3 weeks, you will have a follow-up appointment to assess your healing and determine what you can expect from your sleep apnea moving forward.

Possible complications from UPPP surgery

As with any type of surgery, there are risks and complications that can be associated with UPPP. Some potential complications are considerably more prevalent than others, although most complications are uncommon. In general, complications can include:

• Infection.
• Blood clots.
• Swelling or bleeding where the tissue was extracted.
• Changes in your voice: Your voice may sound different after your surgery. Consonants that require the use of the uvula, known as uvula consonants, might become difficult. These consonants (commonly written with dots or dashes above them) are prevalent in languages like French, Hebrew, Dutch, and Swedish.
• Scar tissue: Once your surgery is complete, scar tissue can accumulate around the incision sites. In some circumstances, this scar tissue can cause your throat to feel closed in or inflamed, or like you have something stuck in your throat. Although this complication isn’t common, when it does happen, it might require further surgery to thoroughly clear.
• Liquid may go up your nose when you drink: This is caused by a complication called velopharyngeal insufficiency. And it essentially means that the soft palate and throat aren’t coordinating enough when you swallow. Typically, when this complication takes place, it’s not permanent.

Be sure to speak with your surgeon about all the potential risks from UPPP. Making sure you’re well-informed and answering all of your questions is an essential step that your surgeon will take.

Is UPPP effective?

So here’s the final question, is UPPP surgery effective? And what can patients expect when the procedure is over? The answer is that for most well-qualified patients, UPPP does give considerable and lasting relief from obstructive sleep apnea symptoms.

As previously noted, not everybody will be well-qualified for this surgery. Less qualified people may still get positive results but they usually won’t last as long.

Here are some things you could experience after your surgery:

• More restful sleep.
• An improved ability to focus throughout the day.
• More energy.
• Less snoring.
• Fewer headaches.

For some, the need to use a CPAP machine will be completely eliminated. But a CPAP machine might still need some use for some individuals. Your symptoms will continue to be monitored after your surgery.

Are there any other alternatives to surgery?

Sleep apnea can definitely be managed in other ways besides surgery. For people who have tried other therapies with little to no results, UPPP surgery may be the best solution. The decision is in the hands of the patient and with our assistance, we can figure out your comfort level.

Having said that, it’s important to remember that UPPP is only effective in a very specific set of patients for a very specific set of symptoms.

How to sleep better

Your sleep cycle can be disrupted by obstructive sleep apnea, even if you’ve slept all night long. For people with specific forms of sleep apnea, uvulopalatopharyngoplasty can give a substantial and effective treatment.

You should get in touch with us right away if you’re having a hard time sleeping or if you think you might have sleep apnea. Treating sleep apnea, in some cases, can be fairly simple. Surgical intervention may be required in other more specialized situations.

Whether you’re dreaming about spelling bees or not, the objective is to get a good night’s sleep.

Call us today if you think you might have sleep apnea, we’re here to help!