UPPP-Is it so bad?
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UPPP-Is it so bad?

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Posted by sleepsurgeon on February 27, 2009 at 20:50:07:

Many postings have raised the issue of how poorly people do with UPPP. Some have wondered why surgeons offer this procedure. First, UPPP is one of the most commonly performed procedure in the world for OSA. There have been extensive studies evaluating the effectiveness of UPPP. The bottom line is that UPPP does improve sleep apnea. However, the extent of improvement varies greatly. In general, favorable factors are patients that are young, have large tonsils and have mild to moderate degree of sleep apnea. I would offer procedures such as UPPP, nasal surgery and/or genioglossus advancement when I think that there is a decent chance that the patient will respond (I have certainly been wrong). However, I often stress to them that MMA is much more predictable and achieves a much greater improvement. The problem is that many patients are turned off by MMA and won't even consider it. In patients with mild to moderate sleep apnea and with favorable factors, it really comes down to their choice in selecting the procedures. In patients with severe sleep apnea, I would steer them toward MMA as the only procedure they should consider.

Another important issue to discuss is the side effects of UPPP, which can be quite common. I personally believe it is all related to the elimination of the uvula. This topic has been extensively discussed in the "ask a sleep specialist" section and I would like to direct you all to question #34.

For patients with favorable factors that are considering UPPP, discuss the procedure with your surgeon. Ask whether they would be willing to preserve your uvula (at least a small portion of it). By doing so, you will have minimal risk for sides effects.

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