Palate Surgery for Obstructive Sleep Apnea

Palate surgery, also known as uvulopalatopharyngoplasty or UPPP, is a procedure used to treat obstructive sleep apnea. Palate surgery originally involved significant tissue removal, including the entire uvula. Today, the procedure involves more tissue repositioning rather than removal.

There are many ways to do palate surgery. UChicago Medicine offers the latest techniques, including:

  • Pharyngoplasty
  • Expansion sphincter pharyngoplasty
  • Lateral pharyngoplasty
  • Barbed suture pharyngoplasty

Your sleep surgeon will work with you to determine which is best for you.

Frequently Asked Questions About Palate Surgery

You must first undergo a medical evaluation to review your past sleep study records, medical history and in many cases have a diagnostic evaluation with a drug induced sleep endoscopy (DISE).

Patients who would benefit from palate surgery typically have one of two significant palate abnormalities on their DISE exam. The palate collapses circumferentially or back-to-front (anterior-posterior.)

Patients with anterior-posterior collapse are also considered good candidates for an Inspire procedure. For patients with circumferential collapse, a staged approach to treatment may be beneficial – where treatment includes palate surgery and Inspire surgery.

  • Palate surgery is performed under general anesthesia in the operating room.
  • During the procedure, the airway is approached through the mouth using a device to visualize the throat.
  • The tonsils will be removed, allowing for exposure and visualization of the muscles at the back of the throat.
  • The muscles are repositioned to open the airway and prevent collapse.
  • The tissue is held in place with dissolvable sutures that typically take a few weeks to either dissolve or fall out.

After surgery, patients are kept overnight at the hospital for observation and pain control. Your care team will give you clear, detailed care instructions and an appointment will be scheduled one week after surgery.

  • You should expect to be off work for about one to two weeks and no heavy lifting or vigorous activity for two weeks.
  • During this time, you will be provided pain medication and rinses to help your throat heal.
  • Eat a soft diet during this time. Protein shakes are a helpful nutrition supplement.
  • It is important to monitor for any bleeding. If this occurs go to the emergency room for evaluation.

Additional appointments will be scheduled one month after surgery and again at three months for additional testing. Once effective treatment is confirmed, patients typically follow up once a year to ensure their sleep apnea symptoms are not returning and no new issues are arising.

Pain with a palate surgery is most like a tonsillectomy. You will receive adequate pain medication in the postoperative period. At your one-week follow-up appointment, your physician can help you address any issues with your recovery.

The surgical changes are permanent and designed to last for years. However, weight changes can affect anatomy.

Patients must avoid heavy lifting for two weeks after surgery to prevent complications. After that, you may return to all normal activities, including sports.

Uvulopalatopharyngoplasty is associated with a potential complication called velopharyngeal insufficiency, where the palate does not move adequately after the procedure. This was more common with outdated tissue removal techniques rather than the tissue-preserving measures currently used for surgery.

Expect some water to go up toward the back of the nose for a few weeks after surgery. Permanent issues are very rare.

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You can also make an appointment with our providers by:

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To speak to someone directly, please call 773-702-1865. If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.

 

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