Definition & Overview
Uvulopalatoplasty is the surgical removal of the uvula to treat loud snoring and relieve symptoms of sleep apnea and other sleep-related breathing disorders. This procedure is sometimes referred to as laser assisted sleep apnea and snoring surgery because it can be performed using laser technology.
The uvula, sometimes referred to as the palatine uvula, is the small flesh extending at the back of the soft palate and hangs at the back of the throat. There are several functions attributed to the uvula. It helps fight infections as well as lubricates the throat during speech and ingestion of food. It also helps prevent gag reflex during swallowing.
Who Should Undergo & Expected Results
Uvulopalatoplasty was originally developed to eliminate loud and habitual snoring. The removal of uvula helps to widen the airways, reducing tissues being vibrated when fast moving air passes through the mouth. Loud snoring typically worsens with age and studies have shown that this condition affects more men than women in all age brackets.
Those diagnosed with upper airway resistance syndrome could also benefit from laser assisted sleep apnea and snoring surgery. This condition is characterised by obstructive breathing during sleep, leading to insomnia and extreme sleepiness during the day.
Uvulopalatoplasty is also recommended for those suffering from mild obstructive sleep apnea, in which patients stop breathing for several seconds during sleep. This leads to low oxygen level in the blood and patients would often wake up gasping for air.
However, the procedure is not recommended for people who have severe sleep apnea, hyperactive gag reflex, or cleft palate. It is also not for people with hypertension or have bleeding disorders, especially those taking anticoagulants.
This surgical procedure has favourable outcomes, with several patients reporting significant improvement in their quality of life. Following the procedure, patients are advised to avoid strenuous activities as well as smoking and alcohol intake.
Pain in the throat and hoarseness of voice are expected following surgery but these typically resolve on their own a few days after the procedure.
How Does the Procedure Work?
Laser assisted sleep apnea and snoring surgery is performed in an outpatient setting for several treatment sessions. Both the surgeon and the patient, as well as assisting medical personnel, are required to wear laser safety goggles. The patient is then administered with anaesthesia to numb the throat and other adjacent parts. The surgeon then uses carbon dioxide laser to make incisions on the soft palate on both sides of the uvula. The same laser is also used to cut and remove the uvula, along with some parts of the soft palate.
Possible Complications and Risks
The use of local anaesthesia during uvulopalatoplasty could cause allergic reactions in some patients. Additionally, patients could experience bleeding during and after surgery though most episodes are manageable and do not need emergency care.
Also, some patients report pain that lasts longer than usual that require the use of pain medications for several weeks. The surgical site might also become infected and swell, requiring antibiotic medication as well.
After uvulopalatoplasty, regurgitation is a common complaint especially during the first few days following the procedure. Liquids and food particles come back up, sometimes through the nose. Though it causes discomfort, this condition rarely becomes permanent.
One rare complication is the narrowing of the area behind the palate. This makes nose breathing, speaking, and swallowing quite difficult. If this occurs, it would typically require additional surgery to resolve.
In some cases, uvulopalatoplasty fail to resolve the condition and recurrent snoring is experienced by a small number of people following the procedure.
Aurora RN, Casey KR, Kristo D, et al. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep. 2010;33(10):1408-13. PMID: 21061864 www.ncbi.nlm.nih.gov/pubmed/21061864.
Braga A, Grechi TH, Eckeli A, et al. Predictors of uvulopalatopharyngoplasty success in the treatment of obstructive sleep apnea syndrome. Sleep Medicine. 2013 Dec;14(12):1266-71. PMID: 24152797 www.ncbi.nlm.nih.gov/pubmed/24152797.