Functions of the uvula and Z-pharyngoplasty

Modified uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea-hypopnea syndrome: Resection of the musculus uvulae

Objective: To assess the outcome of a modified uvulopalatopharynbgoplasty (UPPP) technique with preservation of the uvula mucosa and partial resection of the musculus uvula.

Study Design and Methods: A prospective randomized controlled trial. Sixteen male patients underwent a classic UPPP, and another 16 male patients underwent a modified UPPP. The parameters evaluated were the subjective symptom score, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Stanford Sleepiness Scale (SSS), and polysomnography results.

Results: Postoperative snoring, apnea, morning headache, daytime sleepiness, pharyngeal foreign body sensation, and global discomfort were not significantly different between the two groups. Among seven subjective measures of sleep quality from the PSQI, the subjective sleep quality was significantly improved in both groups. Postoperatively, the SSS was not significantly changed in both groups; however, the ESS was significantly improved in both groups. The polysomnographic findings showed a statistically significantly improvement in the apnea index and the apnea-hypopnea index.

Conclusion: Although the modified group did not have more profound improvement in sleep quality and decreased postoperative pharyngeal discomfort, modified UPPP was an effective surgical method for the treatment of obstructive sleep apnea-hypopnea syndrome.

Why do we have a uvula?: literature review and a new theory

From ancient times up to the present day many different functions and conditions have been attributed to the uvula, many speculative and some with a more scientific basis. The uvula has been shown to have the ability to produce and secrete large quantities of thin saliva. A common complication of surgery involving removal of the uvula is pharyngeal dryness. We have observed that on phonation and swallowing the uvula swings back and forth in the oropharynx. We present a review of the literature on the uvula and propose a theory that the uvula bastes the throat and thereby helps keep it moist and well lubricated.

Z-pharyngoplasty for sleep disorder and rhonchopathy

We developed an operation that leaves the uvula intact and opens the pharynx by creating a Z-shaped incision in the palate, a procedure known as a Z-pharyngoplasty (ZPP). Twenty-four patients were studied before and after ZPPs. None of the patients complained of symptoms after the procedure. In terms of subjective changes, 79% of patients felt that they could breathe better after ZPPs and 75% felt that they had slept well upon waking. In terms of differences noted by sleep monitoring, the minimum oxygen saturation (SaO2) level increased significantly (p = 0.0025), the number of hours of sleep during which SaO2 was > 95% increased significantly (p = 0.0345), the apnea index decreased significantly (p = 0.0316), snoring decreased (p = 0.0637) and pulse rate decreased significantly (p = 0.0144) after ZPP.