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Summary

Uvulectomy is a surgery in which the uvula, a small tongue-shaped tissue suspended from the roof of the back of your throat, is partially or completely removed. Uvula prevents the entry of food into our nasal cavity while swallowing. When the uvula becomes swollen or enlarged, it blocks the airway and contributes to breathing disorders such as sleep apnoea and snoring. These conditions cause sleep disturbances, and in turn, affect your everyday life. 

During uvulectomy, the affected portion of the uvula is cut either by electric current or radiofrequency energy. The surgery lasts for about 10-15 minutes and you may be discharged on the same day. Your doctor will advise you to rest for 10-15 days at home before resuming daily activities.

  1. What is uvulectomy?
  2. Why is uvulectomy recommended?
  3. Who can and cannot get uvulectomy?
  4. What preparations are needed before a uvulectomy?
  5. How is uvulectomy done?
  6. How to care for yourself after uvulectomy?
  7. What are the possible complications/risks of uvulectomy?
  8. When to follow up with your doctor after a uvulectomy?

Uvulectomy is a surgical procedure that is done to remove a part or whole of the uvula, which is a small tongue-shaped tissue suspended from the roof of the back of your mouth.

The uvula, along with the back portion of the roof of our mouth (soft palate), work in tandem in the swallowing process. Both of them move upwards while swallowing to prevent the entry of food into the nasal cavity. However, certain conditions result in a swelling or enlargement of the uvula. This, in turn, can block the airway and cause snoring or sleep apnoea (a condition wherein the airway gets frequently blocked during sleep). Removal of the uvula may be recommended to provide relief from both these conditions.

Uvula is generally not considered to be a crucial organ; however, complete removal of the uvula is associated with dry throat, swallowing problems, and a sensation of a lump in the throat. Therefore, many surgeons do not recommend completely removing the uvula; instead, partial removal of the uvula is recommended.

Your doctor will recommended a uvulectomy if you have any of the following symptoms or conditions that may be associated with an enlarged uvula:

  • Snoring
  • Nasal regurgitation (the re-emergence of swallowed food from the nose)
  • Emetic effect (such as nausea or vomiting)
  • Velopharyngeal insufficiency: A condition in which the soft palate (back part of the roof of the mouth) does not properly close against the back wall of the throat. It leads leads to the following symptoms:
    • Squeaking or snorting sound while talking
    • Speaking loudly
    • Tightening of facial muscles while talking
  • Sleep apnoea: Symptoms of sleep apnoea other than snoring are:
    • Feeling tired and sleepy during the day
    • Frequent episodes of waking up from sleep
    • Breathing difficulty
    • Making choking or snorting noises
  • Uvulitis: Symptoms of this condition are:
    • Fever
    • Reduced appetite
    • Pain while swallowing

A surgeon may not perform this uvulectomy if:

  • You are pregnant
  • You have a smoking habit
  • You have a heart/lung/kidney disease

The surgeon will instruct you to visit the hospital or clinic for a preoperative assessment, wherein you will be asked to share details about:

  • Your medical history
  • If you are using any medicines (currently and previously used)
  • If you have a health condition, allergy or a known history of reaction to anaesthesia.

You will have to undergo some basic tests, such as blood and urine tests. These tests help assess your overall health and fitness for the procedure. Additionally, you will be asked the following:

  • Whether you are pregnant
  • To stop smoking and discontinue taking blood thinning medications, such as ibuprofen, aspirin and warfarin.
  • To start fasting from midnight of the day prior to the surgery. This is to prevent vomiting under the influence of anaesthesia.
  • To inform if you have cold or fever in the days leading to the surgery.
  • To remove your make-up, body piercings and nail polish, and shower before arriving at the hospital on the day of the surgery.
  • To arrange someone (close relative or friend) to drive you home after discharge from the hospital.
  • To sign a consent form, giving your approval for the surgery.

After you arrive at the hospital, you will be asked to wear a hospital gown. The procedure may involve the following steps:

  • The hospital staff will insert a tube in a vein in your hand to provide you with essential fluids, medications and anaesthesia during the procedure.
  • An anaesthesiologist will administer general anaesthesia to put you into sleep during the surgery and prevent you from experiencing any surgery-related pain.
  • Once the anaesthesia takes its effect, the surgeon will cut the affected part of your uvula by using an electric current or radiofrequency energy.
  • He/she will then stitch the operated area with self-dissolving stitches.

The procedure may take about 15–20 minutes. Usually, patients are discharged on the same day after a uvulectomy. However, your surgeon may want you to stay at the hospital overnight so he can monitor your condition.

You may notice some side effects including bad breath, ear pain, sore throat, nausea and vomiting, white patches near the operated area, slight fever (<101°F), constipation and trouble swallowing after the surgery. These are normal and would clear on their own in a few days.

The stitches in your throat will also dissolve on their own within a few days. The surgeon will give you the following instructions (following) for self-care after the surgery:

  • Take lots of liquids; however avoid citrus juices as they can irritate your throat.
  • Eat soft foods during the initial two weeks after surgery. Avoid hot foods, nuts, crackers, chips, popcorn, raw fruits and vegetables as they may cause irritation in your throat. You can gradually start eating solid foods as your appetite improves.
  • Avoid strenuous or heavy exercises for the initial two weeks after the surgery.
  • Rest for at least 48 hours after the surgery. You may be allowed to resume work after 10–14 days.
  • To resolve bad breath for the initial two to three weeks following the surgery, you can try chewing gum or gargling with mild saltwater solution.
  • The surgeon will prescribe medications if you experience severe ear or throat pain. However, these medications can worsen sleep apnoea and cause constipation.

When to see the doctor?

Call your surgeon immediately if you experience any of the following symptoms after the surgery:

  • Fever with a temperature ≥101°F
  • Uncontrolled nausea and vomiting
  • Breathing issues due to swelling in the throat
  • Pain that cannot be controlled after taking medications
  • Chills lasting for more than 12 hours
  • Continued bleeding from the surgery site
  • Coughing up blood
  • Vomiting blood.

The possible risks or complications associated with the surgery are as follows:

  • Bleeding from the nose or throat
  • Risks of general anaesthesia
  • Pain
  • Infection or swelling in the throat
  • Vomiting or nausea
  • Narrowing of airway due to formation of scar tissue
  • Acid reflux (irritation in the food pipe)

Some of the risks associated with a complete uvulectomy are:

The surgeon will schedule you for a follow-up appointment within two weeks of the surgery.

Disclaimer: The above information is provided purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Intermountain Healthcare [Internet]. Utah. US; Uvula Removal Surgery
  2. Jefferson Health [Internet]. Jefferson University Hospitals. Pennsylvania. US; Partial Uvulectomy
  3. National Cancer Institute. [Internet]. National Institute of Health. U.S. Department of Health & Human Services; Mouth.
  4. Chang ET, Baik G, Torre C, Brietzke SE, Camacho M. The relationship of the uvula with snoring and obstructive sleep apnea: a systematic review. Sleep Breath. 2018;22(4):955–61. PMID: 29524092.
  5. Bristol, North Somerset and South Gloucestershire CCG [internet]. National Health Service. UK; Uvula Removal
  6. Cleveland Clinic [Internet]. Ohio. US; Velopharyngeal Dysfunction (VPD)
  7. National Health Service [Internet]. UK; Sleep aponea
  8. UFHealth: University of Florida Health [Internet]. University of Florida. US; Uvulitis
  9. Smith G, D'Cruz JR, Rondeau B, et al. General Anesthesia for Surgeons. [Updated 2020 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan
  10. Townsend Courtney, Beauchamp R. Daniel, Evers B. Mark, Mattox Kenneth. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017
  11. Jacobson R, Ladizinski B, Lee KC. Uvulectomies and associated complications. JAMA Dermatol. 2013;149(1):32. PMID: 23324753.
  12. Ravesloot MGL, Vries N de. A good shepherd, but with obstructive sleep apnoea syndrome: traditional uvulectomy case series and literature review. J Laryngol Otol. 2011 Sep;125(9):982–6. PMID: 21733276.
  13. Beth Israel Lahey Health: Winchester Hospital [Internet]. Winchester. Maryland. US; Uvulopalatopharyngoplasty
  14. American Sleep Apnea Association [Internet]. Washington DC. US; Nasal surgery
  15. The University of Mississippi Medical Center [internet]. University of Mississippi. US; Home care after sleep surgery – Uvulopalatopharyngoplasty (UP3) and/or tonsillectomy
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