Effect of UPPP on the Soft Palate Morphology

Effect of UPPP on the Soft Palate Morphology

by Carlos A. Morales-Ryan DDS, MSD, Patricia Garcia-Morales DDS, MSD, Larry M. Wolford DMD

Purpose:
To evaluate the long term effect of the uvulopalatopharyngoplasty (IUPPP) on the soft palate morphology and the upper airway space changes.

Methods:
This retrospective study included 12 patients (5M and 7F), that underwent concomitant UPPP and orthognathic surgery. Standardized lateral cephalograms immediate presurgery (T1) and long term follow-up (T2) were digitized and measurements recorded included:

  1. soft/hard palate angle (SPA) measured from anterior nasal spine to posterior nasal spine to the lowest border of the soft palate,
  2. soft palate length (SPL) measured from posterior nasal spine to the lowest border of the soft palate,
  3. soft palate width (SPW) measured at the thickest portion of the soft palate using a perpendicular line from the soft palate length,
  4. upper airway space (UAS) measured horizontal from the postero-superior border of the soft palate to the anterior pre-vertebral soft tissue,
  5. lower airway space (LAS) measured horizontal from postero-inferior border of the soft palate to the anterior pre-vertebral soft tissue.

Also surgical and post- surgical complications related to the procedure were recorded. Descriptive statistics and t-test were used to evaluate the data.

Results:
Total sample average age was 40.6 yrs (R 14 to 62 yrs). Long term follow up average 23.8 months (R 12 to 60). There was a statistical significant difference for all the measurements before surgery and at long term follow-up. There was a statistical significant decrease (p less than 0.001) in the SPA (- 10.6°), SPL (-15mm) and SPW (-1.6mm). There was a statistical significant increase (p less than 0.001) in the UAS (4.4mm) and the LAS (5.0mm). No additional complications were encountered by performing this procedure concomitant with orthognathic surgery.

Conclusions:
The results of this study showed a significant increase in airway space and the shortening of the soft palate length when performing the UPPP concomitant with orthognathic surgery. Using the appropriate technique, this procedure does not add any additional complications showing long-term stable results.

References:

  • Wolford LM, Mehra P. Modified uvulopalatopharyngoplasty: the lateral inversion flap technique. J Oral Maxillofac Surg 2001 59(10):1242-3.
  • Mehra P, Downie M, Pita MC, Wolford LM. Pharyngeal airway space changes after counterclockwise rotation of the maxillomandibular complex. Am J Orthod Dentofacial Orthop 2001 120(2):154-9.