Uvulopalatopharyngoplasty
(UPPP; UP3)
Definition
Uvulopalatopharyngoplasty (UPPP) is surgery to take out excess tissue from the back of the mouth and the throat.
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Reasons for Procedure
UPPP is most often done to treat sleep apnea. This causes pauses in breathing during sleep. Rarely, it may be done to treat severe 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 treatments haven't worked.
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems such as:
- Excess bleeding
- Reaction to anesthesia
- Nausea or vomiting
- Infection
- Vocal changes
- Swallowing problems
- Reduced sense of smell
- Scar tissue, which may lead to a nasal blockage
Some people don't respond to this surgery. Other methods to control sleep apnea may still be needed.
Your chances for problems are higher for:
- Smoking
- Drinking
- Chronic disease such as diabetes or obesity
This surgery is more successful in those who maintain a healthy weight.
What to Expect
Prior to Procedure
You may have:
- A 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.
- Don't eat or drink anything after midnight the night before.
Talk to your doctor about the medicines you take. You may need to stop taking some medicines up to 1 week in advance.
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. Cuts will be made to take out excess tissue. Your tonsils and adenoids may also be taken out at this time. A special tool with an electrical current, or clamps and ties will be used to stop bleeding. Stitches may also be used to close some cuts.
Immediately After Procedure
You will be taken to a recovery room.
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. Medicines will ease pain afterwards.
Average Hospital Stay
The usual length of stay is 1 day. This is 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
The healthcare staff will watch your vital signs. They may also give you:
- Pain medicine
- Antibiotics to prevent infection
- Steroids to ease swelling
During your stay, the healthcare staff will take steps to lower your chances of infection such as:
- Washing their hands
- Wearing gloves or masks
There are also steps you can take to lower your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare staff to do the same
- Reminding your healthcare staff 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 such as fever or chills
- Pain that you can't control with the medicines you were given
- Excess bleeding or pus from the wound
- Nausea or vomiting
- Signs of dehydration such as not passing urine for 8 or more hours
- Breathing problems
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
American Academy of Otolaryngology—Head and Neck Surgery
https://www.entnet.org
American Sleep Apnea Association
https://www.sleepapnea.org
CANADIAN RESOURCES:
Canadian Sleep Society
https://css-scs.ca
Canadian Society of Otolaryngology
https://www.entcanada.org
REFERENCES:
Uvulopalatopharyngoplasty (UP 3). Ear, Nose, and Throat Center of Utah website. Available at: https://www.entcenterutah.com/adult-care/surgery/pdfs/Post-Operative-Instructions/Uvulopalatopharyngoplasty-post-op-instructions.pdf. Accessed August 13, 2018.
Surgery for sleep apnea. American Sleep Apnea Association website. Available at: https://www.sleepapnea.org/treat/sleep-apnea-treatment-options/sleep-apnea-surgery. Accessed August 13, 2018.
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.
Last reviewed May 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 8/13/2018