California Sleep Institute


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Uvulopalatopharyngoplasty UPPP for Obstructive Sleep Apnea

There are many modifications to the traditional UPPP technique that improve the airway at this level. Laser removal of tissues gained popularity several years ago because it could be done as an outpatient or office procedure. Radiofrequency (TCRF) has nearly completely replaced the laser technique due to the pain associated with the laser.

The team of highly successful and well-respected Doctors at the California Sleep Institute has developed a palatal flap procedure that creates a flap of the uvula and free edge of the soft palate. This limits pain and there is no free wound edge, as is seen in the traditional UPPP or LAUP. If there are problems with speech and/or swallowing this revolutionary technique can be adjusted to compensate. It can also be completely reversed.

Please click below to review our investigation on this technique.**

  • Powell N, Riley R, Guilleminault C, Troell R: A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep 1996;19(7):593-599

UPPP Uvolplatopharyngoplasty

What is UPPP?

UPPP (or UP3 for short) stands for Uvulopalatopharyngoplasty. It is a surgical procedure that removes or repositions excess tissue from the soft palate and uvula. This technique will focus on shortening of the uvula (the small tissue that hangs at the back of the throat), a portion of soft palate, and may also include the tonsils, and in children the adenoids.

Different Approaches to UPPP Surgery

Some patients undergo UPPP surgery as a standalone operation while others have it as a first step in a phased surgical plan. There are different techniques to performing this procedure. Laser removal gained popularity due to the fact that it can be done as an outpatient or in-office procedure. There is excessive pain involved with the laser procedure as well as the possibility of recurring treatments. It has, for the most part, been replaced by radiofrequency.

California Sleep Institute surgeons Drs. Robert Riley and Nelson Powell previously developed a modified UPPP procedure that creates a tissue flap of the uvula and free edge of the soft palate. This approach reduces pain and allows the procedure to be reversed in the early stages of healing (1-10 days). This procedure is rarely used but is very valuable for professionals such as singers.

Powell N, Riley R, Guilleminault C, Troell R: A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep 1996;19(7):593-599

What Should I Expect After the UPPP Technique?

It can be very uncomfortable for the first 2-3 days and each day the discomfort decreases. Liquid pain medicine can control this discomfort, and we usually expect that pain medications can taper off in 2-7 days. If the tonsils are also included it is well known to be associated with more discomfort and the healing process is slightly prolonged. We suggest liquids to include soups for the first 2 days and then a soft diet for the next 1-2 weeks. Routine office visits are also recommended to reassure and support the patients concerns and questions.

Who is qualified to perform UPPP Techniques?

Dr. Robert Riley and Dr. Nelson Powell have over fifty years of combined surgical experience. They have performed thousands of successful surgeries in the area of sleep related procedures. Their entire careers have been completely dedicated to the medical and surgical management of sleep disorders. Other physicians at the California Sleep Institute include Dr. Jerome Hester, and Dr. Stephen Schendel, each a board-certified sleep surgeon.

Together with sister organizations the California Ear Institute ( CEI ) and the Sinus Institute at CEI, these three organizations can provide an integrated approach to solving sleep/ sinus/ hearing/ balance disorder issues unparalleled anywhere in the world.
Selection of an experienced surgeon at a state-of-the-art facility with the most up-to-date training is essential to having the best chance of a good outcome with your uvulopalatopharyngoplasty ( UPPP ) surgery.

For a detailed treatment rationale indications and outcomes, continue to MANAGEMENT OF SLEEP-DISORDERED BREATHING