Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-06-04T11:52:44.621Z Has data issue: false hasContentIssue false

121 - Uvulopalatopharyngoplasty

Published online by Cambridge University Press:  12 January 2010

John M. DelGaudio
Affiliation:
Emory University, School of Medicine, Atlanta, GA
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Robert B. Smith
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Nathan O. Spell
Affiliation:
Emory University, Atlanta
H. Kenneth Walker
Affiliation:
Emory University, Atlanta
Get access

Summary

Uvulopalatopharyngoplasty (UPPP) is a procedure performed on adults for the treatment of obstructive sleep apnea (OSA). UPPP involves removing the posterior aspect of the soft palate including the uvula and lateral pharyngeal mucosa (or tonsils if present) to reduce redundant tissue, thereby enlarging the oropharyngeal and nasopharyngeal airway.

OSA is a condition affecting 4% of the adult population and manifests by repeated episodes of apnea or hypopnea during sleep. During deeper levels of sleep, especially that characterized by rapid eye movement (REM), there is loss of the normal tone of the pharyngeal and tongue muscles that keep the pharynx open, resulting in collapse of the oropharyngeal and nasopharyngeal airway and varying degrees of airway obstruction. Narrowing of the airway causes increased velocity of inspiratory airflow in the pharynx, causing decreased intraluminal pressure, further tissue collapse, and increased airway obstruction (Bernoulli's principle). In instances of complete airway obstruction, the patient will experience apnea, a cessation of breathing for at least 10 seconds. Incomplete obstruction may result in hypopnea, a reduction in airflow with associated oxygen desaturation, which is more common. Each apnea or hypopnea episode continues until the patient awakens to a more shallow level of sleep, which results in a recovery of pharyngeal muscle tone and recovery of airway integrity. The more frequent the apnea and hypopnea the more fragmented the sleep, resulting in greater sleep deprivation due to the lack of adequate REM activity.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 755 - 756
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fujita, S., Conway, W., Zorick, F., & Roth, T.Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol. Head Neck Surg. 1981; 89: 923–934.CrossRefGoogle Scholar
Mickelson, S. A. & Hakim, I.Is postoperative intensive care monitoring necessary after uvulopalatopharyngoplasty? Otolaryngol. Head Neck Surg. 1998; 119: 352–356.CrossRefGoogle ScholarPubMed
Riley, R. W., Powell, N. B., Guilleminault, C., Pelayo, R., Troell, R. J., & Li, K. K.Obstructive sleep apnea surgery: risk management and complications. Otolaryngol. Head Neck Surg. 1997; 117: 648–652.CrossRefGoogle ScholarPubMed
Sher, A. E., Schectman, K. B., & Piccirillo, J. F.The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996; 19: 156–177.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×