A too-long soft palate can be the cause of obstructive sleep apnea in some cases. Although there are treatments available to enable the individual to breathe clearly, such as CPAP and BiPAP, surgery to remove some of the soft palate is one of the most effective treatments. In most cases, however, surgery will be the last option as many other treatments are just as successful, if not more successful than surgery.
In What Circumstances Is Soft Palate Surgery Necessary?
Usually, if the obstructive sleep apnea is not caused by excess weight or your tongue falling into the back of your throat, the culprit is often excessive soft tissue in the back of the throat, a floppy uvula and a too-long soft palate. If other treatment options, such as CPAP or mandibular advancement devices are not tolerated or do not give the desired effect, surgery may be the answer. Your doctor will always try to treat you as far as possible without resorting to surgery.
The aim of soft palate surgery is always to reduce or prevent completely the collapsibility of the area around the throat. This is done by reducing the amount of soft palate and sometimes, if necessary, removing the tonsils. Often, surgery will include removal of the uvula.
What Happens During Surgery?
That vastly depends on the type of surgery you have. There are four major types of surgery for soft palate removal, and they are as follows:
- Uvulopalatopharyngoplasty (UPPP). This surgery involves removing the uvula, part of the soft palate and often the tonsils. It is performed under general anesthetic. This is the most effective procedure if your palatal obstruction is caused by the side walls collapsing against each other. Side effects include long-term voice changes, persistent dryness, partial loss of taste and regurgitation of food through the nose. This is also a difficult surgery to recover from and patients can be afflicted with very severe post-operative pain.
- Laser-Assisted Uvuloplatoplasty (LAUP). LAUP is a viable alternative to UPPP and is thought to be more comfortable for the patient, as well as cheaper for the hospital. It can also be performed under only a local anesthetic in some cases, making it less risky than UPPP. The surgery involves vaporizing the edge of the soft palate and the uvula with the laser. Unlike UPPP, LAUP can be repeated up to four times until the desired effect has been reached. Post-operative pain is thought to be the same with LAUP patients as UPPP patients, and one downfall of this surgery is that it is very difficult to perform on individuals who have a strong gag reflex.
- Palatal Stiffening (CAPSCO). This surgery is a cauterizing surgery that burns the palate, causing ultimate stiffening of the palate. It can also be used to remove a strip of the palate if needed. Like LAUP, this surgery can be repeated until the desired effect has been reached. It can be performed under local anesthetic during an out-patient visit, making recovery time quicker, but post-operative pain is thought to be on a par with UPPP and LAUP.
- Radio-frequency ablation (Somnoplasty). A relatively new surgery that gets rid of redundant soft palate tissue. It involves heating the inner tissue of the palate to 85C which results in the tissue underneath the outer skin becoming scarred, which shrinks the tissue. It can be performed under local or general anesthetic although some physicians prefer to perform the procedure under general anesthetic as the techniques of the surgery are still relatively new. Patients are generally not very impressed with the surgery and a study showed that 7 out of 11 patients were unhappy with the results.
Other soft palate surgeries include injection Snoreplasty, pillar procedure and septoplasty. For more information on soft palate surgery, talk to your doctor.