Uvulopalatopharyngoplasty (UPPP)Uvulopalatopharyngoplasty (UPPP) is indicated primarily for the treatment of obstructive sleep apnea syndrome (OSAS) due to retropalatal airway obstruction. Because of the redundant size of the soft palate structures in certain patients with OSAS, the airway collapses partially or completely in this location when a person sleeps. This results in a marked narrowing of the airway and prohibits normal respiration. Signs such as snoring or gasping to breathe may be witnessed. Symptoms vary depending on the severity of the OSAS. Daytime sleepiness and cognitive dysfunction are usually noted as well as causing or exacerbation medical conditions such as high blood pressure, gastroesophageal reflux disease, as well as a significant strain on the heart and lungs. By reducing the volume of the soft palate structures, one can partially or totally alleviate the collapse during sleep. The soft palate is a very important complex structure that includes the uvula and soft tissue that separates the back of the mouth (oral pharynx) from the back of the nose (nasopharynx). These structures act like a valve during speech and swallowing to adjust the amount of communication between these spaces. Therefore, a UPPP is a partial resection of these tissues with the intent to leave enough soft tissue to function properly but not too much that these tissues obstruct during sleep. In addition to removing the redundant soft tissue, any palatine tonsillar and adenoid tissue present is also removed as part of the procedure. Techniques have changed over the years with regards to the specific tools used in surgery. Regardless of the technique, the main drawback is postoperative pain. Dr. Speyer uses cold steel dissection with bipolar cautery for bleeding. For any tonsil and adenoid tissue, a cold coblator is utilized in an effort to reduce post-operative pain. Dr. Speyer will discuss the risks, benefits, and alternatives to this procedure with you in detail. Listed below are some of the disclosed risks of undergoing uvulopalatopharyngoplasty, tonsillectomy and adenoidectomy. By reading and signing below, you are stating that you indeed understand the nature of the procedure, the risks as listed, and alternatives to undergoing the procedure. Risks of Uvulopalatopharyngoplasty, tonsillectomy and adenoidectomy include, but are not limited to, bleeding (immediate and delayed), infection, failure to resolve all of the obstructive symptoms, the need for revision surgery, post-operative scarring and globus sensation (cotton ball in throat feel), as well as pharyngeal and palatal closure problems (oropharyngeal and/or velopharyngeal stenosis or insufficiency). The latter, although may persist, is usually temporary. You should not undergo this procedure if you have a wound healing disorder, a history of having received radiation treatments to your throat, uncontrolled diabetes or other serious medical conditions, sarcoidosis, among others. Lastly, since the procedure is performed under a general anesthetic, this alone carries its own risks regardless of the surgery considered. You should discuss the specific risks with the anesthesiologist during your preoperative anesthetic appointment. To fully understand the effect that this procedure has on your sleep apnea, a post-operative sleep study is necessary. Typically this is arranged approximately 8-12 weeks after surgery.
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