Overview

Uvulopalatopharyngoplasty (UPPP) is a surgical procedure to remove excess tissue in the throat to widen the airway, commonly performed for obstructive sleep apnea.

UPPP is crucial for treating obstructive sleep apnea and severe snoring when conservative measures fail.

Learn more in our comprehensive RxDx ENT Course

Indications

✓
Obstructive Sleep Apnea

Confirmed by sleep study

✓
Severe Snoring

Disruptive snoring

✓
Failed CPAP

Intolerance to CPAP

✓
Anatomical Obstruction

Redundant oropharyngeal tissue

✓
Recurrent Tonsillitis

With airway compromise

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Uncontrolled bleeding
✗ Severe coagulopathy

Relative Contraindications

✗ Active infection
✗ Recent surgery
✗ Morbid obesity

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient assessment, sleep study review, equipment setup, and understanding contraindications.

Step-by-Step Procedure

Step 1: Patient Preparation

Position patient, administer anesthesia.

⚠️ Common Mistakes to Avoid:

  • Poor positioning
  • Inadequate anesthesia

💡 Pro Tip:

Use proper positioning.

Step 2: Incision

Make incision in soft palate and uvula.

⚠️ Common Mistakes to Avoid:

  • Wrong incision
  • Inadequate exposure

💡 Pro Tip:

Use proper technique.

Step 3: Tissue Resection

Resect excess tissue.

⚠️ Common Mistakes to Avoid:

  • Excessive removal
  • Bleeding

💡 Pro Tip:

Use careful technique.

Step 4: Hemostasis

Control bleeding.

⚠️ Common Mistakes to Avoid:

  • Inadequate hemostasis
  • Post-op bleeding

💡 Pro Tip:

Ensure complete hemostasis.

Step 5: Closure

Close incision and provide instructions.

⚠️ Common Mistakes to Avoid:

  • Poor closure
  • Poor instructions

💡 Pro Tip:

Use proper technique.

Step 6: Post-procedure Care

Monitor and provide instructions.

⚠️ Common Mistakes to Avoid:

  • Poor monitoring
  • Inadequate instructions

💡 Pro Tip:

Provide clear instructions.

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Post-procedure Care

Post-procedure care involves pain management, monitoring for complications, and long-term follow-up.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 2-5% Active bleeding Packing, cautery Proper hemostasis
Infection 1-2% Fever, pain Antibiotics Sterile technique
Velopharyngeal insufficiency 1-3% Nasal regurgitation Speech therapy Conservative resection
Dysphagia 1-2% Difficulty swallowing Diet modification Conservative resection

Clinical Pearls

💡

Use conservative resection.

🎯

Ensure adequate hemostasis.

⚡

Avoid excessive removal.

🔍

Check for complications.

📊

Document procedure details.

🎨

Provide clear post-op instructions.

⚠️

Monitor for complications.