Uvulopalatopharyngoplasty or UPPP

The UPPP procedure is recommended for severe obstructive sleep apnea. The otolaryngologist removes the soft tissue on the back of the throat including the uvula and parts of the soft palate and the throat tissue behind it. If tonsils and adenoids are present, they are also removed. The goals of this surgery are to:

• Increase the width of the airway at the throat’s opening
• Block some of the muscle action in order to improve the ability of the airway to remain open
• Improve the movement and closure of the soft palate.

Patient Instructions

Please read and familiarize yourself with these instructions both BEFORE and AFTER surgery. By following them carefully, you will assist in obtaining the best possible results from your surgery. If questions arise, please contact our physicians or nurses.

PRE-OPERATIVE:

• If you experience signs or symptoms of an upper respiratory infection or other illness within five days prior to surgery, please call our Surgical Coordinator at (610) 879-0068.
• Do not take any aspirin or aspirin-containing, ibuprofen or ibuprofen-containing drugs for one week prior to surgery. Examples of these include Aspergum, Darvon, Fiorinal, Norgesic, Advil, Motrin and many over-the-counter cough and cold preparations. Additionally, you should not take any nonsteroidal anti-inflammatory drugs such as Naprosyn which have a similar effect. If you are on this type of medication, please discuss this matter directly with us before stopping it.
• Do not eat or drink anything, including water, after midnight prior to surgery.
• The physician will provide you with prescriptions for medications to take at home following surgery. Please be prepared by filling your prescriptions prior to your surgery. Take only the medications prescribed by your physician(s).

POST-OPERATIVE:

• Any pain medications prescribed by our physicians are safe to use in the post-operative period. For children, liquid acetaminophen (brand names Tempra and Tylenol) may be used with a dosage determined by the age of the child. Adults may use tablets or capsules of acetaminophen with the same brand names.
• Moderate to severe pain and slight fever are common for a period of one to two weeks after the procedure. Some ear discomfort is normal and should be expected. Please call our office if you have a temperature over 100 degrees.
• After surgery snoring may be louder until the swelling has regressed. Generally the end results of surgery will not be appreciated for a period of six weeks. Patients who have severe apnea and are on CPAP should plan on continuing the CPAP during the immediate post-operative period (four to six weeks). You should contact the distributor of your CPAP device in order to familiarize yourself with the mechanism of lowering the pressure which may be required during this period.
• Using a bedside humidifier may help reduce throat discomfort, especially in cold weather or if your bedroom environment is dry.
• If gargling is authorized by your physician, gargling with a mixture of one tablespoon of peroxide in a cup of warm water three or four times a day for a period of two weeks is recommended. This will help relieve objectionable mouth odor. Otherwise, avoid gargles. Cepastat Throat Lozenges every two hours as needed or Chloraseptic Spray three or four times a day are also helpful in relieving discomfort and lessening mouth odor.
• Prescriptions that were given should be taken as directed. These will include an antibiotic which is usually given as a suspension, a decreasing dose of a steroid, Viscous Xylocaine (a gel-like liquid which anesthetizes the throat and should help relieve pain), and Carafate Suspension. For pain, Elixir of Tylenol with Codeine, Lortab Elixir or Percocet can be taken every four hours as needed. Oxycontin may be prescribed and is taken every twelve hours.

ACTIVITY:

• After discharge from the hospital, you may not return to work for a period of five to ten days or longer, depending upon the severity of your apnea. During this time strenuous activities and exercise should be avoided.
• Most patients find that sleeping with their head slightly elevated (30 degrees) results in less swelling, and is more comfortable than sleeping supine.

DIET:

• It is very important that you drink the equivalent of at least eight large glasses of water a day.
• Avoid caffeinated products.
• Avoid carbonated, very cold, and very hot beverages. Also avoid acidic foods (such as orange juice) and excessively salty foods.
• A gradual advancement of diet from soft and bland to normal foods over seven to fourteen days is required.
• Most patients experience some regurgitation of liquids (particularly thin liquids) into the nose immediately after surgery. As the swelling regresses and you learn to compensate, this will clear over a period of several weeks. However, some patients do describe a permanent problem with water regurgitating into their noses when they bend over at a water fountain.

If you have any questions concerning your comfort or care, please contact our office at (610) 879-0068.

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