Uvulopalatopharyngoplasty (UPPP)

Uvulopalatopharyngoplasty (UPPP) is a surgical procedure used to remove excess tissue in the throat to make the airway wider. Your doctor will recommend this surgery to treat your snoring or sleep apnea. During UPPP, the tonsils and soft tissue in the back of the throat are taken out. This helps prevent blockage of the airway during sleep. In most cases, UPPP can permanently improve sleep apnea and reduce snoring.

Preparing for surgery

Prepare for the surgical procedure as you have been instructed. Be sure to tell your doctor about all medicines you take, including over-the-counter drugs, herbs and other supplements. You may need to stop taking some or all of them before the surgery as directed by your doctor. Also, follow any directions you’re given for not eating or drinking prior to the surgery.

The day of surgery

The surgical procedure takes about 60 minutes. If you are having UPPP combined with nasal surgery, your experience will be a little different than what is described here. In that case, your doctor will tell you what to expect.

Before the surgery 

Here's what to expect before the surgical procedure begins:

• An IV line is inserted into a vein in your arm or hand. This line carries fluids and medicines.
• You will be given anesthesia to keep you free of pain during the surgery. This will likely be general anesthesia, which puts you into a deep sleep during the surgery.

During the surgery

Here's what to expect at the time of surgical procedure: 

• A special device holds your mouth open. Pillows may be placed under your shoulders and on either side of your neck to support your head.
• If you still have tonsils, these will likely be taken out.
• The soft tissue at the back of your mouth (soft palate) is trimmed. The small piece of flesh that hangs down from the soft palate (uvula) is taken out.
• The ends of the remaining tissue are closed with sutures (stitches). The sutures dissolve on their own in a few weeks.
• You may have an injection of local anesthesia. This aids in preventing pain after surgery.

Recovering in the hospital

After the surgical procedure, you will be taken to a room to wake up from the anesthesia. Initially, your throat will feel very raw. It will be difficult to talk and swallow. You may also feel drowsy and nauseated. You will receive pain medicine. If you still feel pain, tell the doctor or nurse. If you have sleep apnea, you will likely stay overnight in the hospital so your breathing can be closely monitored. Once you are ready to go home, you will be released to an adult family member or friend.

Recovering at home

When you get home, follow the instructions you have been given. You will have throat pain as you recuperate. This may come and go. It’s normal for pain to increase few days after the surgical procedure, before it starts to improve. It may take about 3 weeks for the pain to go away completely. Eating and drinking will probably be uncomfortable for about 5 days. During your recovery:

• Take all medicines as instructed, including pain medicine.
• Do not drive while you are on opioid or narcotic pain medicine. You may feel drowsy or dizzy while you are taking this medicine.
• Drink lots of water, cold liquids, non-citrus juices and frozen juices.
• Stick to cold foods and soft foods, which are easiest to swallow. Try ice cream, gelatin, eggs, pasta and mashed potatoes. Do not eat hot, spicy, acidic, hard or crunchy foods.  
• Avoid coughing or clearing your throat for two weeks.
• Do not use ibuprofen or aspirin for 14 days after the surgical procedure, unless your doctor says it’s OK.
• Limit exercise as directed. Your doctor will let you know when you can return to your normal activities.
• Follow instructions for when to start using continuous positive air pressure (CPAP) if it is recommended.

When to call your doctor

Be sure you have a contact number for your doctor. When you get home, call if you have any of the following:

• Chest pain or trouble breathing
• Fever of 100.4°F (38°C) or higher
• Bleeding from the mouth or nose
• Severe pain not relieved by medicine
• Signs of dehydration
• Bleeding in the throat at any time
• Inability to eat or drink at all for 2 to 3 days 

Follow-up

During follow-up visits, your doctor will check on your healing. A sleep study may be done a few months after the surgical procedure. This helps show whether your sleep apnea has improved. If you are still not sleeping normally, other treatment alternatives may be required.

Risks and possible complications

Risks of UPPP include:

• Bleeding, which may happen a week or more after the surgical procedure (usually needs treatment)
• Severe throat pain during the healing period
• Changes in the sound of your voice
• The feeling that something is stuck in your throat (may last 6 to 12 months)  
• Liquids going into the nose when swallowing
• Failure to cure sleep apnea
• Risks of anesthesia

Disclaimer: The information provided herein is for patient general knowledge only and should not be used during any medical emergency, diagnosis or treatment of any medical condition. Duplication for personal and commercial use must be authorized in writing by Surjen.com.