Uvulopalatopharyngoplasty (functional pharyngoplasty)

Uvulopalatopharyngoplasty (UPPP), also referred to as UP3 surgery, is a functional pharyngoplasty surgery that opens the airways by removing extra tissue in the throat. The back of the throat, called the soft palate, can collapse, making it difficult for air to move through. A blocked airway that prevents air from moving through your windpipe while you sleep is called sleep apnea. UPPP removes or changes the position of the tissue at the back of the throat to treat obstructive sleep apnea and snoring.

Functional pharyngoplasty is performed by an ear, nose, and throat (ENT) specialist, also known as an otolaryngologist.

Your doctor may recommend UPPP surgery if you have mild obstructive sleep apnea or severe snoring. UPPP can help patients who have been unsuccessful at treating sleep issues with lifestyle changes such as weight loss, different sleep positions, using a continuous positive airway pressure (CPAP) machine, or nasal-expanding strips.

Each patient responds differently to treatment depending on their anatomy and other factors. Your doctor will provide more information about your specific situation.

Before your uvulopalatopharyngoplasty, your doctor will explain how the procedure is done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery. For example, you can expect the following:

• Your surgery will be done at a hospital or surgery center.
• You will be asked to stop eating or drinking the night before your surgery. If needed, you can take medications with a small sip of water.
• If you use a CPAP machine, your doctor may ask you to bring it to the hospital.
• You will have anesthesia with sedation, so you are asleep and pain-free during surgery.
• Surgery will take about two hours.

Your doctor will remove the soft tissue at the back of your throat, including some or all of the following:

• Soft palate: The flesh at the back of your throat
• Uvula: The soft flap of tissue that hangs down at the back of your mouth
• Tonsils: Two fleshy mounds at the back of your throat

Patients who undergo functional pharyngoplasty surgery may experience pain or discomfort after surgery. Your care team at Penn Medicine will ensure you receive the right medications to keep you comfortable as you heal. You may have stitches that will dissolve or be removed at your follow-up visit two to three weeks after surgery.

To aid in your recovery, your provider may recommend the following at-home care tips:

• Avoid heavy lifting for two weeks; light activity is OK after the first day
• Drink liquids and eat soft foods for the first two weeks after surgery
• Rinse your mouth with a salt-water solution after every meal for seven to 10 days

Uvulopalatopharyngoplasty is a safe treatment for sleep apnea. The risk of serious complications is relatively low, but like any medical procedure, there are some potential risks, including temporary damage to the throat and soft palate muscles, dehydration, scar tissue, and speech changes.

Complications during any surgery, including allergic reactions to medicine, bleeding, blood clots, breathing problems, or infection, are rare but possible. Your Penn Medicine team is skilled and experienced and will do everything possible to provide the best care during and after your surgery. It’s important to communicate any unexpected side effects with your provider so that we can help you with the management and treatment of these effects.

The Ear, Nose and Throat (ENT) team specializes in advanced treatments for head ailments. With a commitment to providing the highest quality care and the most advanced treatments, our physicians are uniquely qualified to treat each condition individually. When you work with our health care teams, you can expect:

• Multidisciplinary care: Penn otolaryngologists often work with allergists, pulmonologists, endocrinologists, gastroenterologists, and neurologists in managing head and neck disorders.
• Care close to home: Penn doctors meet with patients in satellite locations across the region, allowing convenient consultations, second opinions, and pre-and post-operative care right in your community.