Laser Assisted Uvula Palatoplasty

The Problem:

Some 45 percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons and it usually grows worse with age. Snoring sounds are caused by an obstruction to the free flow of air through the passages at the back of the mouth and nose.

Only recently have the adverse medical effects of snoring and its association with Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS) been recognized. Various methods are used to alleviate snoring and/or OSA. They include behavior modification, sleep positioning, Continuous Positive Airway Pressure (CPAP), jaw adjustment techniques, Uvulopalatopharyngoplasty (UPPP), and Laser Assisted Uvula Palatoplasty (LAUP).

What is Laser Assisted Uvula Palatoplasty (LAUP)?

LAUP allows treatment of snoring and mild OSA by removing the obstruction in your airway in an outpatient setting under local anesthesia. A laser is used to vaporize the uvula and a specified portion of the palate in a series of small procedures. LAUP is performed while you are positioned in an upright sitting position in an examination chair.

Before administration of anesthesia, you are informed that the back of your throat will become numb and that you will lose the sensation of swallowing and breathing. A local anesthesia is sprayed over the back oral cavity, soft palate, tonsils, and uvula followed by an injection of additional anesthesia in the muscle layer of the uvula. After several minutes, a CO2 laser is used to make both, vertical incisions in the palate on both sides of the uvula. The uvula is shortened, eliminating the obstruction that has contributed to the snoring.

LAUP requires up to five treatments spaced four to eight weeks apart (although one to three are usual).

How long will it take to recover?

If you undergo the LAUP procedure you can expect to return to a normal routine almost immediately. For the majority of those undergoing this procedure there will be swallowing pain similar to a severe sore throat. This discomfort lasts for approximately ten days and can be relieved by oral analgesic and anti­inflammatory medicines.

Improvement is noted by the reduction in or disappearance of your snoring.

Should you consider LAUP?

If your snoring is habitual and disruptive to others, you may be a prime candidate for LAUP. Your otolaryngologist will evaluate you and ask the following questions:

• Do you snore loudly and disturb your family and friends?
• Do you have daytime sleepiness?
• Do you wake up frequently in the middle of the night?
• Do you have frequent episodes of obstructed breathing during sleep?
• Do you have morning headaches or tiredness?

Suitability for LAUP is determined after a review your health history, lifestyle factors (alcohol and tobacco intake as well as exercise), cardiovascular condition, and current medications in use. You will also receive a physical and otolaryngological (ear, nose, and throat) examination to evaluate the cause of the snoring.

Before the laser procedure is conducted, you will participate in a "sleep study," which will grade the level of actual snoring and sleep apnea. This will complete the evaluation necessary for prescribing the appropriate treatment for your needs.

© 2004 AAO-HNS/AAO-HNSF