Revised uvulopalatopharyngoplasty with uvula preservation and its clinical study.
OBJECTIVE
A revised uvulopalatopharyngoplasty (UPPP) is reported for reducing the surgical complications without compromising the response.


METHODS
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.
Han
Demin
D
The Department of Otolaryngology, Beijing Tongren Hospital, Capitol Medical University, Beijing, China.
Ye
Jingying
J
Lin
Zhonghui
Z
Wang
Jun
J
Wang
Jiangyong
J
Zhang
Yuhuan
Y
D000273:Adipose Tissue / Q000601:surgery; D000328:Adult; D015992:Body Mass Index; D003251:Constriction, Pathologic / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010156:Palatal Muscles / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000517:prevention & control; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000601:surgery; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*; D014681:Velopharyngeal Insufficiency / Q000517:prevention & control