The uvula is the small, teardrop-shaped piece of soft tissue that hangs from the back edge of the soft palate at the back of the throat. It is composed of connective tissue, muscle fibers, and glands that produce thin saliva to keep the throat moist. When swallowing, the uvula and soft palate move backward to prevent food and liquid from entering the nasal cavity. The uvula can be surgically removed or shortened, but this procedure is rarely performed in isolation. Uvula removal or reduction is typically done as part of a larger surgery intended to widen the upper airway and improve breathing.
Medical Reasons for Uvula Removal
The most common reason for uvula removal or reduction is to treat obstructive sleep apnea (OSA) or severe, chronic snoring. When a person sleeps, throat muscles relax, and an excessively long or large uvula can vibrate, causing snoring. In serious cases, the tissue collapses backward, partially or completely blocking the airway and causing OSA. Reducing the size of the uvula helps stabilize the soft palate and prevents tissue from obstructing the breathing passage, especially when non-surgical treatments like Continuous Positive Airway Pressure (CPAP) fail. Other indications include chronic uvulitis (persistent inflammation or infection) or, rarely, hereditary angioedema, which causes severe swelling of the airways. The decision to remove the uvula is always based on a thorough examination to confirm that the uvula is contributing significantly to the patient’s symptoms.
The Surgical Procedures Involved
The most frequent procedure that includes uvula removal or reduction is Uvulopalatopharyngoplasty (UPPP). UPPP is a comprehensive surgery designed to treat airway obstruction by removing and reshaping excess tissue in the throat. During the procedure, the surgeon may remove the tonsils, parts of the soft palate, and all or part of the uvula to enlarge the passage behind the soft palate.
The surgery is performed under general anesthesia. The surgeon uses instruments like a scalpel or electrocautery to precisely remove the targeted structures, and the remaining tissue edges are then sutured together to create a wider and more stable airway.
A less extensive procedure is Uvulopalatoplasty (UP) or Laser-Assisted Uvulopalatoplasty (LAUP), which focuses on shortening or stiffening the uvula and soft palate tissue. LAUP is usually performed for primary snoring rather than severe OSA. Isolated uvulectomy, the complete removal of the uvula without altering surrounding structures, is the least common approach, as obstruction usually involves the soft palate as well.
Immediate Post-Operative Effects and Recovery
Recovery from UPPP involves significant post-operative pain, which often intensifies on the second or third day following surgery. This severe pain can persist for up to two weeks, requiring prescription pain medication for management. Swelling may temporarily worsen sleep apnea symptoms, sometimes requiring overnight hospital observation to monitor the airway.
Hydration is a concern, as the pain makes swallowing difficult and increases the risk of dehydration. Patients must consume only soft foods and liquids for the first 10 to 14 days to prevent irritation and bleeding at the surgical site. Crunchy, sharp, or highly acidic foods should be avoided until the throat has healed completely.
Other acute effects include referred pain felt as an earache and bad breath caused by the scabs that form over the healing tissue. Full recovery, allowing normal activities to resume, often takes between three and six weeks.
Long-Term Functional Changes
One potential long-term effect of uvula removal is velopharyngeal insufficiency (VPI). VPI occurs when the soft palate cannot fully close off the nasal cavity during swallowing, which can lead to the temporary or chronic regurgitation of liquids or food into the nose.
Changes in voice quality, specifically hypernasality, may also occur because the altered shape of the soft palate affects how air resonates during speech. Although often temporary, this change can occasionally be lasting.
Some patients report chronic sensations in the throat, such as persistent dryness or a feeling that a lump is present, known as pharyngeal dysesthesia. This dryness is related to the removal of the uvula’s saliva-producing glands and the change in airflow dynamics.