How Painful Is UPPP Surgery?

Uvulopalatopharyngoplasty (UPPP) is currently the most common surgery performed for obstructive sleep apnea (OSA) or snoring
Uvulopalatopharyngoplasty (UPPP) is currently the most common surgery performed for obstructive sleep apnea (OSA) or snoring

Uvulopalatopharyngoplasty (UPPP) is currently the most common surgery performed for obstructive sleep apnea (OSA) or snoring in the United States. It is performed only if weight loss, nasal medications, and nasal dilators do not help reduce snoring.

You will be given general anesthesia through a tube (endotracheal tube) inserted in your mouth or nose. This makes you sleep throughout the surgery and makes the procedure painless for you.

The procedure involves cutting (resection) of the tissue in the throat, including one or more of the following: the uvula, soft palate, and tonsils. It aims to increase the space required for obstruction-free breathing in OSA.

You may have stitches in the back of your throat. This part is sensitive; therefore, the surgery may result in relatively more pain after you recover from the anesthesia. 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

You may also feel some food particles or liquids go up into the nose when swallowing. This is a mild problem that will usually resolve within the first few weeks of healing.

What are the risks of uvulopalatopharyngoplasty?

The common complications of anesthesia and surgery can happen in uvulopalatopharyngoplasty (UPPP) as well. These include:

  • Reactions to medicines
  • Laryngospasm (causes shortness of breathing)
  • Bleeding or hematoma (pooling of blood)
  • Wound infection

Other risks that UPPP surgery carries are:

  • Injury to teeth/tongue/lips
  • Mucus in the throat
  • Speech changes causing a nasal voice
  • Dehydration
  • Persistence of snoring

Injury to the muscles in the throat and soft palate can lead to the velopharyngeal insufficiency, causing liquids from coming up into your nose when drinking.

What happens before the uvulopalatopharyngoplasty surgery?

Your doctor will ask if you are pregnant. If you are into drinking or smoking, they may ask you to avoid them for a few days before the surgery.

Let your doctor know about any cold, flu, fever, or other illness you may have before your surgery. Surgery may get postponed in case of infections.

You may be asked to stop taking blood-thinning medications such as aspirin, ibuprofen, naproxen, clopidogrel, and warfarin a few days before the surgery.

You will likely be asked not to drink or eat anything for several hours before the surgery. Only a few drugs as advised by the doctor can be taken with a small sip of water.

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What precautions to take after the uvulopalatopharyngoplasty surgery?

You will have to stay overnight in the hospital till the doctor ensures you can swallow.

Eat only soft foods and liquids for the first two weeks after surgery. Avoid hard or crunchy foods such as chips.

Rinse your mouth every time after meals with a salt-water (saline) 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 two weeks.

Drink plenty of water. Dehydration can make you feel feverish and weak.

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.

Go easy while cleaning the back of your throat. Don’t try to brush it as the activity could dislodge a scab and result in bleeding.

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

Recovery can take up to 3 weeks. You can resume school or office soon after you start feeling better.

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