• Uvulopalatopharyngoplasty

    (UPPP; UP3)

    Definition

    Uvulopalatopharyngoplasty (UPPP) is surgery to remove excess tissue from the back of the mouth and the throat. The tonsils and adenoids, if present, may also be removed.
    The Mouth and Throat
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    UPPP is most often done to treat sleep apnea which causes pauses in breathing during sleep. Rarely, it may be done to treat excessive snoring. Muscles in the back of your throat relax when you sleep. When the muscles relax, the soft tissue they support can collapse into the airway. The narrowed airway can cause snoring and sleep apnea.
    UPPP removes excess soft tissue to keep the airway open during sleep. It may be done if other methods of controlling your condition have not been helpful.

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Excess bleeding
    • Adverse reaction to anesthesia such as lightheadedness or wheezing
    • Nausea and vomiting
    • Infection
    • Vocal changes
    • Swallowing problems
    • Reduced sense of smell
    • Scar tissue, which may lead to a nasal blockage
    Some patients do not respond to this surgery. Other methods to control sleep apnea may need to be continued after the procedure.
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
    • Smoking
    • Drinking
    • Chronic diseases, such as diabetes or obesity
    This surgery is more successful in those who maintain a healthy weight.

    What to Expect

    Prior to Procedure

    Your doctor may do the following:
    • Physical exam
    • Blood and urine tests
    • Imaging tests
    • Sleep studies
    • A nasopharyngoscopy to view the back of your nose and throat
    Before arriving for surgery:
    • Arrange for someone to drive you home from the hospital.
    • Do not eat or drink anything after midnight the night before the procedure.
    Certain medications may cause complications during the procedure or recovery. These medications may need to be stopped up to one week before the procedure. Talk to your doctor before the procedure about all medications, herbs, and supplements you are taking.

    Anesthesia

    General anesthesia will be used. It will block pain and keep you asleep through the procedure.

    Description of the Procedure

    The doctor can gain access to the area through the mouth. Incisions will be made to remove excess tissue. Your tonsils and adenoids may also be removed at this time. A special tool with electrical current or clamps and ties will be used to stop bleeding at the site. Sutures may also be used to close some incisions.

    Immediately After Procedure

    After the operation, you will be taken to the recovery room for observation.

    How Long Will It Take?

    The length of the procedure will depend on the amount of work you have.

    How Much Will It Hurt?

    Anesthesia will prevent pain during surgery. After surgery, you may have severe pain. Pain can be managed with medications.

    Average Hospital Stay

    This is done in a hospital. The usual length of stay is 1 day to make sure you can swallow. If you have any problems, you may need to stay longer. In other cases, you may not have to stay overnight.

    Post-procedure Care

    At the Hospital
    Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
    • Pain medications
    • Antibiotics to prevent infection
    • Steroids to reduce swelling
    During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
    • Washing their hands
    • Wearing gloves or masks
    There are also steps you can take to reduce your chances of infection, such as:
    • Washing your hands often and reminding visitors and healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incisions
    At Home
    It may take a few days before you are comfortable enough to return to your normal diet or return to work.

    Call Your Doctor

    Call your doctor if any of these occur:
    • Signs of infection, including fever and chills
    • Pain that you cannot control with the medications you were given
    • Excess bleeding or drainage from the incision sites
    • Persistent nausea or vomiting
    • Signs of dehydration, such as not urinating for 8 or more hours
    • Difficulty breathing
    • New or worsening symptoms
    If you think you have an emergency, call for emergency medical services right away.

    RESOURCES

    American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org

    American Sleep Apnea Association http://www.sleepapnea.org

    CANADIAN RESOURCES

    Canadian Sleep Society http://www.canadiansleepsociety.ca

    Canadian Society of Otolaryngology http://www.entcanada.org

    References

    Uvulopalatopharyngoplasty (UP 3). Ear, Nose, and Throat Center of Utah website. Available at: http://entcenterutah.com/files/Uvulopalatopharyngoplasty-post-op-instructions.pdf. Accessed May 5, 2014.

    Varieties of OSA surgery. American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/treat/treatment-options/surgery.html. Accessed May 5, 2014.

    Khan A, Ramar K, Maddirala S, Friedman O, Pallanch JF, Olson EJ. Uvulopalatopharyngoplasty in the management of obstructive sleep apnea: The Mayo Clinic experience. Mayo Clin Proc. 2009;84(9):795-800.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.