Uvulopalatopharyngoplasty (UPPP)
What is UPPP?
Uvulopalatopharyngoplasty (UPPP) is a surgical procedure to treat obstructive sleep apnea (OSA) by removing or reshaping tissues in the throat, including the uvula, soft palate, and pharyngeal walls, to widen the airway and reduce airway collapse during sleep. It’s often considered when non-surgical treatments like CPAP fail. In India, UPPP is performed in ENT departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need UPPP?
UPPP is indicated for:
- Obstructive sleep apnea (OSA):
- Moderate to severe OSA (apnea-hypopnea index [AHI] >15) causing snoring, daytime fatigue, or cardiovascular risks.
- Often linked to enlarged uvula, soft palate, or tonsils (related to tonsillectomy, as you asked earlier).
- Failed non-surgical treatments:
- CPAP (continuous positive airway pressure) intolerance or non-compliance.
- Lifestyle changes (e.g., weight loss) insufficient.
- Anatomical obstruction:
- Excess tissue in the throat (e.g., long uvula, redundant soft palate) contributing to airway collapse.
- Associated procedures:
- May be combined with tonsillectomy or septoplasty (both previously queried) for better outcomes.
The procedure aims to widen the airway, reduce airway obstruction during sleep, decrease snoring, and improve sleep quality, though it may not fully resolve OSA in all cases.
Why Do UPPP Costs Vary in India?
Costs range from ₹50,000 to ₹1.2 lakh :
- Procedure Complexity: Standard UPPP (₹50,000–₹80,000); with tonsillectomy or septoplasty (₹80,000–₹1.2 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹80,000–₹1.2 lakh); lower in government hospitals (AIIMS: ₹20,000–₹40,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced ENT surgeons charge more.
- Additional Costs: Anesthesia (₹5,000–₹15,000), hospital stay (₹5,000–₹15,000/day), medications (₹2,000–₹5,000), sleep study (₹5,000–₹10,000).
- Insurance: Covered for OSA treatment; confirm with your provider.
UPPP Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Sleep study (polysomnography): Confirms OSA severity (AHI score).
- Drug-induced sleep endoscopy (DISE): Identifies sites of airway collapse.
- Throat exam: Assesses uvula, soft palate, and tonsils.
- Blood tests: Blood sugar, clotting profile.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe.
- Consent: Risks, including voice changes, are explained.
- Diagnosis:
- Surgical Techniques:
- UPPP:
- Performed under general anesthesia, lasting 1–2 hours.
- Approach: Through the mouth (no external incisions).
- Tissue removal/reshaping:
- Uvula: Partially or fully removed.
- Soft palate: Excess tissue trimmed or reshaped to widen the airway.
- Pharyngeal walls: Lateral tissue tightened or repositioned.
- Tonsils: Removed if enlarged (tonsillectomy, often included).
- Techniques:
- Cold steel: Scalpel/scissors for tissue removal (traditional).
- Electrocautery: Uses heat to remove tissue and control bleeding.
- Coblation: Radiofrequency energy for precise removal with less damage.
- Bleeding controlled with cautery; sutures may be used to close incisions.
- Intraoperative Tools:
- Mouth gag: Keeps mouth open.
- Electrocautery/coblation device: Removes tissue.
- Endoscope (if DISE used): Visualizes airway.
- UPPP:
- After Surgery:
- Hospital stay: 1–3 days.
- Care: Liquid/soft diet (e.g., ice cream, porridge) for 7–10 days; stay hydrated.
- Pain management: Moderate to severe throat pain for 5–10 days; managed with acetaminophen or prescribed analgesics.
- Instructions: Avoid strenuous activity for 2 weeks; sleep with head elevated.
Recovery After UPPP
- Hospital Stay: 1–3 days.
- Post-Surgery Care:
- Pain: Moderate to severe throat pain for 5–10 days, peaking at days 3–5; managed with medication.
- Diet: Liquids for 1–2 days (e.g., water, juice), then soft foods (e.g., yogurt) for 7–10 days; avoid spicy/hot foods.
- Activity: Rest for 3–5 days; avoid heavy lifting or sports for 2 weeks.
- Breathing/Snoring: Improvement in 2–4 weeks; full OSA benefit may take 6–12 weeks.
- Swelling: Throat swelling for 1–2 weeks; may temporarily worsen snoring.
- Follow-Up:
- Visits at 1 week, 1 month, and 3 months.
- Sleep study: At 3–6 months to reassess AHI and OSA severity.
Most resume normal activities in 7–10 days; full recovery takes 4–6 weeks. Success rate: 60–80% achieve significant OSA improvement (AHI reduction >50%); snoring reduced in 80–90%; some may still need CPAP.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Minor bleeding common; severe bleeding (1–2%) may need return to operating room (esp. days 5–10).
- Infection (1–2%): Throat infection; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to general anesthesia; rare in healthy patients.
- Post-Surgery:
- Velopharyngeal insufficiency (VPI, 2–5%): Nasal regurgitation or hypernasal speech; often temporary, may need speech therapy or revision surgery.
- Swallowing difficulty (2–5%): Temporary; resolves in 1–2 weeks with therapy.
- Dry throat (5–10%): Due to tissue removal; managed with hydration.
- Persistent OSA (20–40%): If other obstruction sites (e.g., tongue base) remain; may need additional surgery or CPAP.
- Long-Term:
- Change in voice (1–3%): Hypernasal tone; usually resolves in 1–3 months.
- Narrowed airway (rare): Scar tissue causing stenosis; may need revision surgery.
Report heavy bleeding, fever, severe pain, or breathing difficulty promptly.
Frequently Asked Questions (FAQs)
What causes obstructive sleep apnea?
Excess throat tissue, obesity, enlarged tonsils, or anatomical issues (e.g., deviated septum); affects 2–4% of adults.
Can I avoid UPPP?
Yes, if mild: CPAP, weight loss, or positional therapy; UPPP is for moderate to severe OSA with anatomical obstruction.
Is UPPP painful?
Moderate to severe throat pain for 5–10 days, managed with medication; improves in 1–2 weeks.
How soon can I resume activities?
Normal activities: 7–10 days; full recovery: 4–6 weeks; avoid strenuous activity for 2 weeks.
Is UPPP covered by insurance in India?
Yes, for OSA treatment; confirm with your provider.
Signs of complications?
Heavy bleeding, fever, severe pain, or breathing difficulty.
Will UPPP completely cure my sleep apnea?
60–80% see significant improvement; some (20–40%) may still need CPAP if other obstruction sites persist.
Lifestyle changes post-surgery?
Soft diet for 7–10 days, avoid irritants (e.g., smoking), maintain weight loss, and attend follow-ups.
Conclusion
UPPP is an effective procedure to treat obstructive sleep apnea by widening the airway, with moderate success in reducing symptoms, though additional treatments may be needed. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult an ENT surgeon for personalized guidance.
Looking for Best Hospitals for UPPP
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
40,000 |
1,50,000 |
Ahmedabad |
60,000 |
2,50,000 |
Ajmer |
40,000 |
1,50,000 |
Aligarh |
40,000 |
1,50,000 |
Allahabad |
40,000 |
1,50,000 |
Amritsar |
50,000 |
2,00,000 |
Aurangabad |
50,000 |
2,00,000 |
Bangalore |
60,000 |
2,50,000 |
Bareilly |
40,000 |
1,50,000 |
Belgaum |
50,000 |
2,00,000 |
Bhopal |
50,000 |
2,00,000 |
Bhubaneswar |
50,000 |
2,00,000 |
Bikaner |
40,000 |
1,50,000 |
Chandigarh |
60,000 |
2,50,000 |
Chennai |
60,000 |
2,50,000 |
Coimbatore |
60,000 |
2,50,000 |
Dehradun |
50,000 |
2,00,000 |
Delhi |
60,000 |
2,50,000 |
Dhanbad |
40,000 |
1,50,000 |
Durgapur |
40,000 |
1,50,000 |
Faridabad |
60,000 |
2,50,000 |
Ghaziabad |
60,000 |
2,50,000 |
Gorakhpur |
40,000 |
1,50,000 |
Guntur |
50,000 |
2,00,000 |
Gurgaon |
60,000 |
2,50,000 |
Guwahati |
50,000 |
2,00,000 |
Gwalior |
40,000 |
1,50,000 |
Hyderabad |
60,000 |
2,50,000 |
Indore |
50,000 |
2,00,000 |
Jabalpur |
40,000 |
1,50,000 |
Jaipur |
60,000 |
2,50,000 |
Jalandhar |
50,000 |
2,00,000 |
Jamshedpur |
50,000 |
2,00,000 |
Jodhpur |
40,000 |
1,50,000 |
kanpur |
40,000 |
1,50,000 |
Kochi |
60,000 |
2,50,000 |
Kolkata |
60,000 |
2,50,000 |
Kollam |
50,000 |
2,00,000 |
Lucknow |
50,000 |
2,00,000 |
Ludhiana |
60,000 |
2,50,000 |
Madurai |
50,000 |
2,00,000 |
Mangalore |
50,000 |
2,00,000 |
Meerut |
40,000 |
1,50,000 |
Moradabad |
40,000 |
1,50,000 |
Mumbai |
60,000 |
2,50,000 |
Mysore |
60,000 |
2,50,000 |
Nagpur |
50,000 |
2,00,000 |
Nashik |
50,000 |
2,00,000 |
Navi Mumbai |
60,000 |
2,50,000 |
Noida |
60,000 |
2,50,000 |
Patna |
40,000 |
1,50,000 |
Pune |
60,000 |
2,50,000 |
Raipur |
50,000 |
2,00,000 |
Rajkot |
50,000 |
2,00,000 |
Ranchi |
40,000 |
1,50,000 |
Surat |
60,000 |
2,50,000 |
Thane |
60,000 |
2,50,000 |
Vadodara |
50,000 |
2,00,000 |
Varanasi |
40,000 |
1,50,000 |
Visakhapatnam |
50,000 |
2,00,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.