What is uvulopalatopharyngoplasty (uppp)?

Uvulopalatopharyngoplasty (UPPP) is a type of surgery to remove tissue from the back of your throat. You will be asleep during surgery. The doctor may remove extra tissue from the uvula, tonsils, or part of the soft palate. The soft palate is the back part of the roof of your mouth. After this tissue is removed, air may move through your throat better when you breathe.

This surgery may be used to improve obstructive sleep apnea that has not been helped by other treatments. Obstructive sleep apnea happens when your throat is narrow or blocked by tissue.

After surgery, you may breathe more easily or even snore less. This surgery may not completely fix the problem if the tongue relaxes when you sleep and blocks the airway. So you may still need to use continuous positive airway pressure (CPAP).

You will probably go home the day after surgery. In about 1 to 2 weeks, you can probably go back to work or most of your usual activities. But you may need 3 to 6 weeks to fully recover.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. Do not lie flat. Sleep with your head up by using extra pillows. You can also try to sleep with your head up in a reclining chair. This can reduce swelling in your throat.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• You may shower or bathe as usual.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for at least 2 weeks or until your doctor says it is okay.
• Ask your doctor when you can drive again.
• You will probably need to take 1 to 2 weeks off from work. It depends on the type of work you do and how you feel.

Diet

• If it is painful to swallow, try eating soft foods like pudding, yogurt, canned or cooked fruit, scrambled eggs, and mashed potatoes. Avoid eating foods that are hard or may have sharp edges like chips or raw vegetables. Avoid orange or tomato juice and other acidic foods that can sting the throat. You may want to avoid eating bananas until your throat is better. They can be painful to swallow.
• Drink plenty of fluids (unless your doctor tells you not to).
• Avoid very hot or very cold foods and liquids.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also be given instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Do not take aspirin, medicines that contain aspirin, or non-steroidal anti-inflammatory medicines such as ibuprofen (Advil, Motrin) or naproxen (Aleve) for 2 weeks after surgery unless your doctor says it is okay.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
• If you think your pain medicine is making you sick to your stomach:
  • Take your pain medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• You may have cuts (incisions) in your throat. The stitches will dissolve and do not need to be removed.

Ice and elevation

• To help with swelling and pain, put ice or a cold pack on your throat for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• Do not lie flat. Raise your head with three or four pillows. This can reduce swelling.

Other instructions

• Use nonprescription anesthetic throat lozenges to soothe pain. Regular cough drops or hard candy may also help.
• Try not to cough or sneeze. But if you must, open your mouth, and cough or sneeze gently.
• Keep your mouth clean. Gargle with warm salt water one time each hour to help reduce swelling and relieve discomfort. Use 1/2 teaspoon (2.5 mL) salt mixed in 1 cup (250 mL) warm water.

UPPP surgery may reduce sleep apnea and snoring for some people. But apnea episodes and snoring may return over time. You may still need CPAP after surgery.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Complications during surgery include accidental damage to surrounding blood vessels or tissues.

Problems caused by surgery may include:

• A sore throat and problems swallowing.
• Speech problems. The surgery may change the sound of your voice.
• Changes in how food tastes.
• Swelling, pain, infection, or bleeding.
• Narrowing of the airway in the nose and throat.
• Sleepiness and periods of not breathing (apnea) related to the medicines that are used to relieve pain and help you sleep.

Uvulopalatopharyngoplasty (UPPP) is surgery to cut away soft tissue in the back of the throat. The doctor may have taken out the uvula. This is the small piece of skin that hangs down at the back of the throat. The doctor also may have taken out the tonsils and part of the soft palate. The soft palate is the back section of the roof of your mouth.

Your throat may be sore for 2 weeks or longer. You may need to wear a breathing mask (CPAP) to help keep your airway open. You may have trouble swallowing, and you may have a mild earache. You may feel like there is something stuck in your throat. You may notice blood in your spit. These symptoms may last for 7 to 10 days.

Your jaws may be sore, and your lips may be chapped. Your doctor may give you a spray to numb your throat instead of pain pills. That's because some pain pills relax the throat muscles. This can cause your airway to narrow.

You will probably be able to go back to work or to most of your usual activities 1 to 2 weeks after surgery. But you may need up to 3 to 6 weeks to fully recover.

Over the next 3 to 6 weeks, you should start to have better airflow. You may find that you snore less or not at all.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take 1 to 2 hours.