What Is Uvulopalatopharyngoplasty Surgery?

Uvulopalatopharyngoplasty (UPPP) is a surgical procedure to remodel the structures in your throat by removing them fully or partially.
Uvulopalatopharyngoplasty (UPPP) is a surgical procedure to remodel the structures in your throat by removing them fully or partially.

Uvulopalatopharyngoplasty (UPPP) is a surgical procedure to remodel the structures in your throat by removing them fully or partially. These structures are as follows:

  • The whole of the uvula or its part (uvula is a soft flap of the tissue that hangs down at the back of the mouth just above the throat)
  • Parts of the soft palate (the roof of the hind part of the mouth)
  • Tonsils and adenoids

Why is uvulopalatopharyngoplasty done?

Uvulopalatopharyngoplasty (UPPP) is currently the most common surgery performed for obstructive sleep apnea (OSA) in the United States.

OSA is a sleep disorder that causes you to transiently stop breathing during sleep. It leads to problems such as daytime sleepiness, hypertension, and an increased risk of a stroke.

The most characteristic feature of OSA is snoring. It happens due to the intermittent collapse of the throat muscles blocking the airway while you are asleep.

Due to troubled breathing, OSA leads to a gradual fall in oxygen concentration. As a result, you experience choking spells that disturb your sleep.

If you are overweight, doctors will initially suggest incorporating lifestyle changes for weight loss. Additionally, they may prescribe you devices or machines such as continuous positive airway pressure (CPAP) that help manage OSA symptoms. If all these conservative measures fail to provide you relief from OSA, your doctor may recommend a corrective surgery such as UPPP. You can also consider the surgery if you do not want to use the devices for OSA for a lifetime.

What are the possible complications of uvulopalatopharyngoplasty?

The risk of serious complications from uvulopalatopharyngoplasty (UPPP) include:

  • Bleeding or hematoma (pooling of blood) at the site of the surgery
  • Wound infection
  • Injury to the teeth/tongue/lips
  • Velopharyngeal insufficiency (injury to the muscles in the throat and soft palate that can lead to velopharyngeal insufficiency; it causes liquids to come up into your nose when drinking)
  • Mucus in the throat
  • Speech changes (nasal voice)
  • Dehydration
  • Post-procedural pain 

How long does it take to recover from uvulopalatopharyngoplasty?

Uvulopalatopharyngoplasty (UPPP) can be performed as an outpatient procedure. If your doctor wants to ensure that you can swallow, you may have to stay overnight in the hospital.

You will experience pain while eating and talking. To alleviate the pain, your doctor will prescribe you pain medications. Other things that can help alleviate the pain include:

  • Drinking cool water or other liquids
  • Application of ice packs to the outside of the neck

Recovery can take up to 3 weeks. You can resume school or office soon after you start feeling better. To speed up the recovery, you should

  • Eat only soft foods and liquids for the first 2 weeks after the surgery. Avoid hard or crunchy foods such as chips.
  • Rinse your mouth every time after meals with saline (saltwater) solution for the first week after the surgery.
  • You may begin walking after 24 hours. You can resume your regular activities gradually day-by-day. Avoid vigorous exercises and lifting heavy weights for the first 2 weeks.
  • Drink plenty of water. Dehydration can make you feel feverish and weak.
  • Go easy while cleaning the back of your throat. Don’t try to brush it because the activity could dislodge a scab and result in bleeding.

You may have a low-grade fever after the surgery and that’s OK. If the fever goes beyond 101°F, call your doctor or visit the nearest emergency room.

You will have a follow-up visit with your doctor probably 2-3 weeks after the surgery.

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References
Uvulopalatopharyngoplasty. Available at: https://emedicine.medscape.com/article/1942134-overview#a3

He M, Yin G, Zhan S, et al. Long-term efficacy of uvulopalatopharyngoplasty among adult patients with obstructive sleep apnea: A systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2019 Sep;161(3):401-411.