Revised uvulopalatopharyngoplasty with uvula preservation and its clinical study

Abstract

Objectives: A revised uvulopalatopharyngoplasty (UPPP) is reported for reducing the surgical complications without compromising the response.

Methods and materials: A new method of performing UPPP was designed, in which the uvula is preserved, but a larger portion of the soft palate is removed. This new procedure is called the 'revised UPPP with uvula preservation' (Han's UPPP or H-UPPP), the characteristics of which are as follows: complete preservation of the uvula; larger portion of the soft palate resected (with the levator palati and tensor palati remaining intact); the adipose tissue in the space of the velum palati is removed; the preserved uvula will become a 'normal' one by the contraction of scar tissue on both sides of the musculus palato-uvularis and the lower margin of the tensor palati. 68 cases of obstructive sleep apnea/hypopnea syndrome had been treated with H-UPPP between September 1998 and May 2001.

Results: Polysomnography was performed for all 68 cases 6 months postoperatively with a surgical response of 69.12%, defined as a >50% reduction of the apnea-hypopnea index and <20 apneic pauses/h; no palatopharyngeal incompetency or palatopharyngeal stenosis. Anatomic measurements showed that the preserved uvula in H-UPPP begins to retract 2 weeks postoperatively, and the preserved uvula becomes 'normal' in 3-6 months.

Conclusions: These results suggest that H-UPPP is an effective surgery and produces fewer complications compared with the classic UPPP.