What is Uvulopalatopharyngoplasty – What is it?

You ever have one of those dreams where you’re back in grade-school, maybe as a contestant in a spelling bee? Everybody but you and one other person is out of the competition. And then… the judges give you your word: uvulopalatopharyngoplasty. And no degree of practice could have readied you for this one. That’s one difficult word to spell (even for an awesome, non-dreaming speller).

That isn’t a fake word, believe it or not. It actually exists. Turns out, uvulopalatopharyngoplasty (called UPPP for short, mercifully) is a surgical procedure designed to help manage obstructive sleep apnea.

When more conservative solutions haven’t been effective, this surgical approach is sometimes used. Obstructive sleep apnea symptoms can be diminished with UPPP, allowing an individual with this condition to get a better night’s sleep.

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 relax, sag, and form a blockage of your airways. As a result of this blockage, you begin to snore, and you stop breathing. Sleep apnea, as a result, can have a negative impact on your sleep schedule.

Sleep apnea can make you feel awful because you can’t sleep soundly through the night, leaving you tired all day. Respiratory disorders, like sleep apnea, should be taken very seriously because they can even result in death in rare cases.

A considerable amount of tissue will be extracted from your throat by your surgeon during a UPPP surgery. When this excess tissue is removed, the obstruction should be cleared. This method was first developed in 1981, and since that time, it’s become an ever more effective option for a specific set of sleep apnea patients.

Is UPPP right for you?

Not every type of breathing disorder requires UPPP. In fact, to be an ideal prospect for UPPP, it’s essential for you to have the right type of sleep apnea. Further, only individuals who have Stage 1 obstructive sleep apnea will likely be helped by this surgery.

We might want to make sure that you’ve exhausted all other treatment solutions. You’re a candidate for UPPP if:

• Stage one sleep apnea has been diagnosed by your doctor. Individuals with Stage 2 or Stage 3 sleep apnea aren’t good candidates for this procedure.
• The desired outcome has not been achieved by lowering your BMI or losing weight.
• Your general quality of life is being negatively affected by obstructive sleep apnea.
• Your soft palate, nostrils, or other soft tissue around your airways has structural issues.
• Your symptoms are not alleviated by any other treatment solutions. You might first try other treatments including a CPAP machine.

It’s essential for anyone who has a sleep-associated condition to get the proper treatment. We will be able to give you a diagnosis after assessing your symptoms. Then we will establish a treatment plan distinct to your situation.

What occurs during a UPPP procedure?

Usually, general anesthesia is used for a UPPP surgery. Which areas of your airways are causing the biggest issue will be established by your surgeon just before the surgery. Why you have so much extra tissue in your throat is something we will need to identify. Every person is a little bit different in this regard.

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

• The ball of tissue hanging down at the back of the mouth, known as the uvula.
• Your tongue may also need to have some tissue taken out. Elimination of tongue tissue is actually a separate procedure known as uvulopalatopharyngoglossoplasty (which is also quite the tongue twister, uh, no pun intended). If you’re a good candidate for this surgery, it’s something your surgeon will talk with you about well in advance.
• Around the throat, any extra tissue. If you still have tonsils and adenoids, this may include them.
• The soft palate which forms the roof of your mouth towards the back of your mouth.

The incisions will be sutured closed by your surgeon at the end of the surgery. UPPP is usually performed on an outpatient basis, but an overnight stay in a hospital is in some cases required. Your local healthcare setting, your general health, and your surgeon are all variables here. Your surgeon will want to be certain you can swallow normally before sending you home.

How do you get ready for your UPPP procedure?

When you’re preparing for your UPPP surgery, you will need to take several steps, just like you would with any surgical procedure. You won’t have any surprises because you and your surgeon will discuss everything well ahead of time.

Here are some preoperative instructions you might get:

• Some over-the-counter medications, particularly painkillers including aspirin and ibuprofen, will thin your blood and should not be used before surgery unless recommended by your surgeon.
• You might be asked to fast for a number of hours before your procedure.
• After your surgery, you will need a ride home and this is especially true if your surgery is on an outpatient basis.
• Your doctor will provide you with a complete list of what to avoid taking and what to continue taking.
• On the day of your procedure, you might be required to take certain medications.
• You will be given guidelines to inform your surgeon if you get sick, even with a cold. Your surgery might have to be rescheduled if you have any illnesses.

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

After surgery – post-operative care

How much tissue that your surgeon takes out will, in large part, determine the length of your recovery. In general, however, you can count on at least 2-4 weeks of recovery time.

You should try not to be too idle, but you should also avoid overly strenuous activity for a couple of weeks. Walking about and doing normal activities will help you avoid blood clotting.

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

• Be limited to soft foods. Immediately after your surgery, you will be limited to clear liquids, but when you feel ready you’ll be able to move on to soft foods. You’ll most likely stay with soft foods until we give you the okay to move ahead.
• Avoid infection by using a salt-water-based mouthwash.
• Experience soreness in your throat. For a few weeks after surgery, this sore throat may linger.

Be certain to ask us any questions you may have about what to expect during recovery. In around 2-3 weeks, you will have a follow-up appointment to evaluate your healing and determine what you can expect from your sleep apnea going forward.

Complications from UPPP

As with any surgical procedure, there are risks and complications that can be related to UPPP. Most complications are pretty rare but some are more prevalent than others. Here are a few possible complications:

• Liquid may travel up your nose when you drink: This is the result of a complication called velopharyngeal insufficiency. It means that when you swallow, your throat isn’t effectively coordinating with your soft palate. This side effect is usually temporary when it occurs.
• Infection.
• Vocal changes: After the surgery, your voice could sound different. If you’ve had tissue from your uvula extracted, you might have trouble making what are known as uvular consonants, which are particularly common in Dutch, French, Hebrew, Swedish, and other languages. (These are the consonants that have the dots or lines above them.)
• Blood clots.
• Swelling or bleeding of the area that was operated on.
• Scar tissue: Scar tissue can build up around the incision during the healing process. In some cases, this scar tissue can cause your throat to feel closed in or irritated, or like something’s stuck in your throat. This complication isn’t common, and it may require additional surgery to entirely correct it.

Your surgeon will be capable of helping you understand all of the risks, so make use of that resource. Your surgeon will be happy to answer your questions and make sure you’re informed!

Does UPPP Work?

So here’s the ultimate question, is UPPP surgery effective? And what can patients expect when the surgery is over? Well, UPPP does offer a considerable amount of lasting relief from obstructive sleep apnea for most well-qualified patients.

Once again, this surgery isn’t for everyone. Less qualified individuals might still get positive outcomes but they normally won’t last as long.

Here are some things you may experience after your surgery:

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

For some people, UPPP will totally eliminate your need to use a CPAP machine. For others, symptoms may improve, but you still may need to use your CPAP machine. After your surgery, we will still monitor your symptoms.

Are there any other alternatives to surgery?

Sleep apnea can certainly be addressed in other ways besides surgery. For individuals who have tried other therapies with little to no relief, UPPP surgery might be the best option. In most circumstances, the choice of whether to pursue UPPP is up to the patient and the provider, and it definitely takes into consideration the comfort level of the patient.

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

How to sleep better

Your sleep cycle can be disturbed by obstructive sleep apnea, even if you’ve slept all night long. Uvulopalatopharyngoplasty can provide effective treatment for individuals with certain types of sleep apnea.

You should get in touch with us as soon as possible if you’re having a difficult time sleeping or if you believe you might have sleep apnea. Sometimes, treating sleep apnea can be a simple fix. In other cases, surgical intervention can offer relief.

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

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