Uvulopalatopharyngoplasty

Uvulopalatopharyngoplasty is a valid treatment of obstructive sleep apnea (OSA) in appropriately selected patients. (Sher AE, meta-analysis).  After a thorough examination, if the primary area of obstruction has been demonstrated to be the collapse of the velopharynx, surgical modification of this area has been demonstrated to be effective with and without adjunctive procedures (Sher, AE meta-analysis and Friedman M, level 3 evidence).  In patients with mild to severe OSA, both simultaneous and serial surgical procedures have been shown to be medically necessary and effective (Friedman M level 3 and Osnes T level 3)

It has been well established that primary surgical treatment should be considered in patients with mild OSA and severe obstructing anatomy that is surgically correctible. (Epstein LJ, Evidence Based Clinical Guideline) In addition, UPPP and other surgical procedures are a successful secondary treatment for OSA and are indicated in patients who have demonstrated treatment failure by continuous positive airway pressure (CPAP) therapy and/or oral appliance therapy. In patients with high AHI, UPPP may also be considered as an adjunct therapy when obstructive anatomy or functional deficiencies compromise other therapies or to improve toler¬ance of other OSA treatments (Epstein LJ, Evidence Based Clinical Guideline).

Adopted 5/6/91
Submitted for Review 4/13/95
Submitted for Review 3/1/98
Reaffirmed 3/1/98

Revised 5/3/2010

Guidelines are not a substitute for the experience and judgment of a physician and are developed to enhance the physicians' ability to practice evidence-based medicine.