Long-term results and complications following uvulopalatopharyngoplasty in 116 consecutive patients

Abstract

A modified uvulopalatopharyngoplasty (UPPP) was carried out between January 1992 and December 2003 at the ENT Department of the Inselspital in Bern in 146 patients with habitual or complicated rhonchopathy. The operation consisted of a classical tonsillectomy or residual tonsil resection and additional shortening of the uvula. The natural mucosal fold between the uvula and the upper pole of the tonsils was carefully preserved. A wide opening to the rhinopharynx was created by asymmetric suturing of the glossopalantine and pharyngopalatine arches. A retrospective questionnaire with regard to rhonchopathy, phases of apnea, daytime drowsiness, obstruction of nasal breathing, long-term complications and patient satisfaction was used to evaluate the short-term and longterm effectiveness of the modified UPPP as well as the incidence of adverse side effects. Complete postoperative courses were evaluated in 116 patients. Surgical complications were restricted to one case with postoperative hemorrhage. A velum insufficiency or postoperative rhinopharyngeal stenosis did not occur. Eighty-three patients (72%) confirmed a persistent suppression or substantial improvement of the rhonchopathy. Disappearance or decrease of sleep apnea was confirmed in 12 (63%) out of 19 postoperative polysomnographic follow-up investigations. Long-term complications occurred in a total of 27 (23%) of 116 patients. They were confined to minor problems such as dryness of the mouth (n = 12), slight difficulty in swallowing (n = 7), discrete speech disturbances (n = 1), and slight pharyngeal dysesthesias (n = 7) with feeling of a lump in the throat and compulsive clearing of the throat. Eightyfive patients (73%) reported that they were satisfied with the postoperative result even several years after the operation. Looking back, 31 patients (27%) would no longer have the operation performed. The inadequate result of the rhonchopathy was specified as the reason by 21 patients. Ten patients had unpleasant memories of the operation because of intensive postoperative pain. Snoring and apneic phases are suppressed or improved by non-traumatic UPPP in the majority of patients. This effect persisted even years after the operation.

Olfactory Loss after Uvulopalatopharyngoplasty: A Report of Two Cases with Review of the Literature

“…It has been suggested that altered nasal structure affects olfactory function in OSAS patients [ 13 ]. UPPP improved nasal breathing in many OSAS patients with impaired nasal breathing, so the olfactory function in OSAS patients might be improved by UPPP [ 13 , 14 ].…”

Oropharyngeal Stenosis

“…1,2 A review of the literature on uvulopalatopharyngoplasty, lingual tonsillectomy, and tongue base reduction procedures performed alone did not show evidence of OPS. 4,[10][11][12][13][14][15][16][17][18] Lin and Koltai 19 noted the potential for adhesions between the epiglottis and the tongue base after coblation lingual tonsillectomy and suggested additional caution during ablation of lingual tonsil tissue in the vallecula.…”

Outcomes of uvulopalatopharyngoplasty with harmonic scalpel after failure of continuous positive airway pressure in sleep apnea syndrome

“…Unexpected scar formation and inappropriate selection of patients for surgical treatment may contribute to these poor success rates [1,2]. For these reasons, continuous positive airway pressure (CPAP) therapy is the treatment of choice for OSA.…”