UPPP Sleep Apnoea Surgery in Sharjah

What is UPPP sleep apnoea surgery?

UPPP sleep apnoea surgery, or uvulopalatopharyngoplasty, is an operation that widens the airway behind the soft palate by removing and reshaping tissue that collapses during sleep. The long name simply lists the parts involved: the uvula, which is the small fleshy tag hanging at the back of the mouth, the soft palate, and the side walls of the throat, called the pharynx.

In obstructive sleep apnoea, a long soft palate, a large uvula and bulky tonsils can crowd the space at the back of the throat. When the throat muscles relax in sleep, this tissue falls backwards and narrows or closes the airway. UPPP trims the uvula and the free edge of the palate, removes the tonsils where they are still present, and stitches the side walls of the throat outwards so the passage becomes wider and firmer.

A detail that surprises many patients: the surgeon keeps the muscle that lifts the palate when you swallow and speak. The palate is shortened and tightened, and it still seals off the back of the nose during swallowing. At Dar Al Kamal Hospital, Sharjah, UPPP is performed in-house by the ENT surgeon as one of the surgical options within sleep apnea treatment.

Who needs it

UPPP suits adults with obstructive sleep apnoea or heavy snoring where the narrowing sits mainly at the level of the soft palate and tonsils. Two pieces of evidence come first. A sleep apnea test confirms apnoea and grades its severity, and the ENT examination, often with a thin flexible camera passed through the nose, shows where along the airway the narrowing happens.

Features that point towards UPPP include:

• A long soft palate or a large, swollen uvula seen on examination
• Tonsils that bulge into the throat from either side
• A clear nose and a roomy space behind the tongue, so the palate is the main problem
• CPAP that has been tried and proved hard to live with, or that needs throat space to work more comfortably

Other options are always part of the discussion. CPAP is the standard treatment for moderate and severe apnoea. Gradual weight loss, sleeping on your side and a dental device that holds the lower jaw forward suit many people with milder apnoea. Tonsillectomy alone may be enough when large tonsils are the main cause, and Inspire therapy is an implanted option for selected people who find CPAP unworkable. The surgeon weighs your sleep study result, your weight, the site of narrowing and your experience of CPAP, and the choice is made together with you.

What happens

UPPP is carried out under general anaesthesia, so you are asleep throughout. The anaesthetist is told in advance that you have sleep apnoea and plans your breathing care before, during and after the operation accordingly.

The whole operation is done through the open mouth, so there is no cut on the skin. A small frame holds the mouth open and the tongue forward. The surgeon removes the tonsils first where present, then trims the uvula and the lower edge of the soft palate. The lining and muscle of the throat side walls are brought together with dissolving stitches, which pulls the palate forward and widens the passage. Bleeding is controlled as the surgeon works.

You wake in the recovery area with a sore throat and a dry mouth. Because sleep apnoea and anaesthetic medicines combine, you usually stay in hospital overnight so nurses can watch your breathing and oxygen level while you sleep. Drinking starts the same day, and you go home once you can swallow fluids and tablets and your pain is controlled.

Preparing for it

A pre-operative assessment, blood tests and an anaesthetic review confirm you are ready. Bring a full list of your medicines; blood thinners, diabetes medicines and anti-inflammatory tablets each need a plan, and you receive clear fasting instructions for the day. If you use CPAP, bring your machine and mask to hospital, since the nurses may use it while you sleep after the operation.

Stopping smoking, shisha and midwakh helps the throat heal. Stock the fridge with cool, soft foods and plenty of drinks before the day. Plan time away from work, and arrange help at home for the first days. If you are thinking about surgery near Ramadan, raise it early: steady drinking through the day is central to throat healing, so the date is best agreed around the fast.

Afterwards

A sore throat is expected, and the pain often reaches the ears, because the throat and ears share nerves. Take pain relief regularly and before meals, as the team advises. Drink often; swallowing keeps the throat muscles moving and helps healing. In the Sharjah heat and in air-conditioned rooms, keep a water bottle beside you day and night. Move from cool, soft foods back to a normal diet as comfort allows.

The voice may sound slightly different while the palate settles, and a little fluid can enter the nose on swallowing in the early days. White patches in the throat are normal healing, similar to those after tonsillectomy. Your surgeon gives you a personal timeline for returning to desk work, driving and manual work. A repeat sleep study, once the throat has healed, measures the change in your apnoea and guides whether CPAP continues.

Contact the hospital urgently if you are unable to drink, have a fever, or the throat pain suddenly worsens. **Go to the emergency department straight away if you spit or vomit fresh red blood, or have difficulty breathing.**

Cost and insurance

Most UAE insurance plans cover UPPP when it treats diagnosed obstructive sleep apnoea, and it almost always requires pre-approval supported by the sleep study report and a record of CPAP use. Some plans exclude surgery carried out for snoring alone. Dar Al Kamal Hospital, Sharjah can help you confirm your cover and start the approval early on 06 599 7777.