Solution to sleep apnea and snoring: Learn about UPPP surgery (Uvulopalatopharyngoplasty)

Do you snore loudly at night when you sleep? Do you sometimes feel like you're stopping for a moment and then suddenly breathing heavily again? Does your family always tell you about this? This condition is medically known as Obstructive Sleep Apnea (OSA) . It disrupts your sleep and can cause long-term health problems. One of the treatments for this is Uvulopalatopharyngoplasty, or UPPP for short. Let's take a look at what it is, who does it, and everything you need to know about it in simple terms.

Simply put, what is UPPP surgery?

Imagine that the airway in your throat is a little blocked. At night, when we sleep, the muscles in your throat relax and this narrows the airway even more. That's when you hear the snoring sound and feel short of breath.

UPPP surgery involves surgically removing or modifying the extra tissue in your throat that is blocking your airway, thereby widening it. It's like removing obstacles on a busy road. When your airway is clear, you can breathe easier at night and sleep better.

During this surgery, the surgeon usually removes or changes these parts:

• Soft palate: The soft, fleshy part behind the hard part at the top of your mouth.
• Uvula: A small teardrop-shaped piece of flesh that hangs from the back of the throat, above the base of the tongue.
• Tonsils: Two lumps of flesh on either side of the throat.

Sometimes this UPPP surgery is done alone. However, for some people, if they are also having trouble breathing due to other problems in their nose or throat, UPPP surgery may be combined with other surgeries to resolve those problems.

In what cases is this surgery performed? Can everyone do it?

No, this is not a surgery for everyone. When treating Obstructive Sleep Apnea (OSA), doctors first try non-surgical treatments.

For example:

• CPAP machine: This is a device that you wear over your nose like a mask while you sleep. It helps keep your airway open throughout the night.
• Lose weight: Being overweight is a major cause of OSA. Losing weight can help control the condition for many people.

If these treatments don't work, your doctor may consider UPPP surgery. There is also a special procedure to determine if you are a good candidate for this surgery. Your doctor will examine the structure of your throat, the size of your tonsils, and your body mass index (BMI).

The doctor who examines you will make the best decision about this. So talk to him/her carefully about this.

How should I prepare before surgery?

Your doctor will explain everything you need to do before the surgery, but in general, you should be aware of these things.

• Tell your doctor your complete medical history: any other illnesses you have, previous surgeries, and any allergies to anesthesia.
• Stop smoking and tobacco use: Smoking can significantly delay wound healing, so it is important to stop smoking completely before surgery.
• Follow instructions about medications and fasting: Your doctor will tell you when to stop eating and drinking before surgery, what medications you should stop taking, and what you should take. Follow those instructions exactly.
• Arrange for someone to drive you home: You will not be able to drive yourself after surgery, so arrange for someone to drive you home in advance. If possible, it is best to have someone to take care of you for the first 24 hours after surgery.
• Bring the CPAP machine to the hospital: If you already use a CPAP machine, bring it to the hospital as directed by your doctor.
• Tell your doctor if you get sick: If you develop an illness, such as a fever or cold, on the days before your surgery, let your doctor know right away. Your surgery may need to be postponed.

What happens during surgery?

There is no reason to be afraid of this. The entire process happens without you knowing anything.

1. First, you will be given a sedative and then put under general anesthesia. This means you won't feel anything, you will be completely asleep.

2. The surgeon will open your mouth with a special instrument, tilt your tongue to one side, and adjust the position so that the inside of your throat can be clearly seen.

3. Then, the unwanted tissue (tonsils, uvula, soft palate) in the throat is carefully removed as planned. This may involve the use of sharp surgical instruments or electrocautery .

4. Finally, the incisions are closed with dissolvable stitches.

The entire surgery can usually take about two hours, depending on the extent of the changes being made to your throat.

How long does it take to recover after surgery?

It can take two to four weeks to fully recover. Many people are unable to go to work or school during this time and have to take time off.

After surgery, you may be able to go home the same day, or you may only need to stay in the hospital overnight. Your doctor will let you go home once your breathing is stable and you can swallow safely.

Expect these things during recovery

• Sore throat: You may feel a sore throat, as if you had a tonsillectomy. This pain may be worse when you speak or swallow something. Don't worry, your doctor will prescribe a good painkiller for this.
• Food and Drink: In the early days, you will only need to drink liquids (water, soup, fruit juice). As you become more comfortable, you can gradually switch to soft foods like porridge, yogurt, and pudding. Avoid eating spicy, sour, hard, and crunchy foods (e.g., biscuits, pickles) completely, as they can make the wound more painful.
• Activity: Avoid heavy lifting or strenuous exercise for the first two weeks. However, instead of staying in bed all day, walking around the house can help prevent blood clots.

What are the benefits and risks of this surgery?

Like any medical treatment, this surgery has benefits as well as some risks.

Benefits

• The biggest advantage is that it makes breathing easier.
• Snoring is greatly reduced or stops completely.
• Since sleep is not interrupted at night, daytime sleepiness and fatigue are reduced.
• For some people, this completely cures Obstructive Sleep Apnea (OSA).
• Others have much less symptoms and may even be able to stop using the CPAP machine.

Risks/Complications

In addition to the common risks of any surgery, such as infection and bleeding, there are several rare complications that are specific to this surgery.

• Nasopharyngeal stenosis: Very rarely, as the wound heals, more scar tissue can form, narrowing the airway again.
• Velopharyngeal insufficiency: When you drink liquids like water, you may feel like they are coming up your nose. However, this is usually temporary and will resolve in a few days.
• Voice change: There may be a slight change in your voice (like a slightly higher pitched voice) for a short time after surgery. This is also usually temporary.

Your doctor will discuss these risks with you before surgery. Don't worry, these don't happen very often.

When should I see a doctor?

It is very important to seek medical advice immediately if any problems arise during recovery.