Palatal Surgery

7/28/2019 Palatal Surgery

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Palatal Surgery


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Palatal surgery is the surgery of the palate alsoknown as roof of the mouth

It is performed under general anesthesia in theoperating room.

Palate surgery (with or without tonsillectomy) isprincipally used to treat obstructive sleep apnea

The procedure involves a combination of tissueremoval and tissue repositioning that aims toincrease the size of the airway without affectingnormal functions such as breathing, speaking,

and swallowing.


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Anatomy of the Oral Cavity

Tongue

Hard Palate

Soft Palate / Velum Uvula


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Anatomy of the oral Cavity


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Palatal surgery includes:

Uvulopalatopharyngoplasty (UPPP or UP3) : its is aprocedure used to remove excess tissue in the throatto widen the airway. The tissues removed mayinclude: 1) Uvula 2) Soft palate 3) tonsils and adenoid4)excess throat tissues.

Palatopharyngoplasty : It is asurgical resection of

unnecessary palatal and oropharyngeal tissue toopen the airway

Uvulopalatal flap: It is a less invasive procedurethat also achieves improvement of the airway. In this

procedure, a small amount of tissue is removed ascompared to uvulopalatopharyngoplasty. Airwayimprovement results from tissue rearrangement bylifting the soft palate to widen the airway


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Indication of palatal surgery

1. Sleep apnea or snoring: In these disorders, the

palate can block the breathing passage during sleep

and interrupt the normal breathing pattern. The palate

can also vibrate during breathing, which creates theloud sounds we know as snoring.

2. Palatal surgery with tonsillectomy is also indicated

in chronically infected or enlarged tonsils which may

cause chronic or recurrent sore throat, bad breath,

abscess, or difficulty swallowing


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COMPLICATIONS

BleedingPalate surgery carries a risk of bleeding, and the risk is higher if tonsillectomy isalso performed.

InfectionInfection is rare but not impossible after palate surgery or tonsillectomy.

Difficulty swallowing

The palate is important in swallowing because it seals the connection between theback of the mouth and the back of the nose.

Changes in speechAny operation on the palate can cause changes in speech, but these changes arerarely permanent.

Narrowing at the top of the throatThis complication can make breathing through the nose difficult as well as create

problems with speaking and swallowing Tooth injury

Operating in the back of the throat is impossible unless an instrument is placed tokeep the mouth open.. Rarely, a tooth may be injured by this instrument, and therisk is much higher if a tooth is loose or decayed prior to surgery.


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MANAGEMENT


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DietDue to the pain and swelling that is to be expected, you will mostlikely only be able to tolerate a liquid diet for the first 4-5 days aftersurgery.

After this period of time, you should transition to soft solid foods

such as eggs . You should be able to tolerate a largely normal diet by 14 days

following surgery. During this period of recovery, you should avoidfoods with sharp edges such as chips because these can causebleeding. Otherwise, you can advance your diet according to yourown schedule, being careful not to cause too much pain.

AntibioticsIt is prescribed to take antibiotic for several days. This can be usefulfor preventing infection and decreasing swelling.


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Minimize strenuous physical activity for four weeksAt a minimum, patients should walk at least three times a daystarting the day after surgery. Walking and spending more time outof bed (walking or in a chair) rather than in bed are helpful becausethey reduce the risks of developing pneumonia or blood clots in the

legs. Jaw discomfort or ear problems

The swelling in your throat that occurs after surgery can cause jawpain or ear symptoms such as pain, pressure, or fullness. This iscommon and should improve within 1-2 weeks following surgery. Itoccurs because the soft palate and tonsils are next to the jaw.

Sleep with head elevated (at 45 degrees) for at least three daysElevating your head during sleep decreases blood flow to the headand neck regions. Therefore, it decreases swelling and theassociated pain. Elevating the head during sleep may also improvebreathing patterns in other ways.


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View of the mouth before palate

surgery

Vi f h h f h li f


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View of the mouth after healing from

uvulopalatopharyngoplasty or

uvulopalatal flap


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View of the mouth after healing from

palatopharyngoplasty

Documents

Palatal Surgery