Complications

The largest study on complication with this procedure suggest a rate of about 4% (Mickelson, 1998). Others have reported rates from 13% to 30%. In the past, this procedure was done much more frequently than it is today, and with less discretion on patient selection. The major reported complications in the literature are difficulties with anaesthetic and intubation, airway problems from swelling after the surgery or from premature extubation, heart problems, bleeding, velopalatine insufficiency (where liquids come out your nose when you drink them too fast – usually temporary but can be permanent), palatal-nasopharyngeal stenosis (scarring behind the palate making the airway even smaller), difficulty swallowing, the sensation of a lump in your throat, worsening of a gag reflex, numbness of the tongue, temporary taste change, and persistent sleep apnea.

The most common complications are bleeding (2 to 4%) and velopalatine insufficiency. It is actually quite common for the first few days after surgery (10 to 20%) that drinking water quickly will result in it coming out your nose. This is temporary and a result of swelling. It is very rare for this to persist more than a few weeks.

What to expect after surgery?

Where you stay the night of surgery depends on the severity of sleep apnea, whether or not you are already using a CPAP machine, and if there are other medical problems. Many patients can go home several hours after their surgery, others are monitored on the wards, others spend a night in the ICU (Intensive Care Unit) for closer monitoring.

To go home there must be:

1. A secure airway (no risk of having breathing difficulties)
2. Drinking enough fluid
3. Pain is well controlled with oral medication.

After surgery I am very careful with any narcotic pain killers, gravol, and I never give sleeping pills. These all relax the airway and decrease the body's drive to breath. There have been reports of serious complications and even deaths because of these medications given after UPPP. At home you should avoid spicy, salty, sour, or sharp foods. You are prescribed pain medications and a ‘miracle mouthwash’. Some people are prescribed a short course of oral steroids to decrease the swelling. You should expect 1 to 3 weeks of pain and recovery and plan for 3 weeks off of any significant physical exercise or labor. Some people only require a few days off. The recovery period is impossible to predict. You will follow-up in one week for stitch removal.