Modified Uvulopalatopharyngoplasty With Uvula Preservation


Introduction

A narrow upper airway is one of the main causes of obstructive sleep apnea (OSA). Uvulopalatopharyngoplasty (UPPP), which ablates both the two tonsils and part of the redundant soft palate to decrease the oropharyngeal obstruction, is used as an alternative treatment for OSA. Application of the classic UPPP is limited by variable effectiveness in unselected patients and a relative high rate of complications, such as palatopharyngeal incompetency and palatopharyngeal stenosis. To reduce the UPPP complication rate without compromising the surgical response, the first author designed a new method of UPPP in which the uvula is preserved, a larger portion of the soft palate is removed, and the basic structure of the oropharyngeal cavity is maintained. This modified UPPP with uvula preservation was first introduced by Han Demin in 2000 and was named Han-UPPP. Han-UPPP is widely used in China and has proved to be an effective surgery and causes fewer complications compared with classic UPPP.

Patient Selection

Indications

  • 1.

    OSA patients with the main collapsing sites at the retropalatal level, which are caused by hypertrophic tonsils, long and enlarged soft palate, and redundant lateral pharyngeal mucosa.

  • 2.

    Nonapneic snorers and patients with upper airway resistance syndrome who have oropharyngeal obstruction.

Contraindications

  • 1.

    Oropharynx is not the primary obstruction site

  • 2.

    Recent upper airway infection

  • 3.

    Evident risk factors of general anesthesia

  • 4.

    Tendency to developing scars

  • 5.

    Unstable cardiovascular or cerebrovascular conditions

  • 6.

    Severe chronic obstructive pulmonary disease

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here