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Sleep Surgeon Question 34

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Question 34 - ‘I had a UPPP to treat apnea and now I’m paying for it’

From: Several Patients

A few of my patients have directed me to the Awake article by a women who regretted that she underwent UPPP for sleep apnea. Below is a link to the article followed by my Response.


Response Provided by Dr. Kasey Li
May 5, 2008

Some of my past and present patients have directed me to the above article. It was written by a woman who regretted having UPPP for the treatment of her sleep apnea due to permanent side effects. The article was nicely written and informative for all, for patients as well as surgeons.

As a surgeon, my responsibility is to improve my patient’s quality of life and alleviate their suffering. What is just as important, is that I do not create major side effects that could make my patients life worse than before their operation. I can’t say that 100% of my colleagues believe in this philosophy, but I believe that overwhelming majority of them share my view. I also can’t say that none of my patients regretted having had an operation, but I believe they are very rare.

One should ask whether UPPP is a good operation for sleep apnea. From my point of view, the answer is no. The important issue here is that although UPPP does help some patients with sleep apnea, it can create side effects such as swallowing difficulties, throat dryness and sensitivity, as Capistrano is experiencing (LAUP is worse).

The central problem is that the operation is flawed in that the uvula is removed. Additionally, delicate tissues are replaced by scars which also contribute to the side effects. I have always lectured on this topic as I have opposed the removal of uvula for many years. I never believed that uvula contributed to sleep apnea and have designed operation to preserve the uvula while expanding the airway (http://www.sleepapneasurgery.com/pharyngoplasty.html).

The key in sleep apnea throat surgery is not how much tissues are removed to open the airway, but is how the airway can be improve by making them less floppy. By preserving important tissues, side effects can be minimized.


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