Dr. Pasha has developed his own unique approach to reconstructing the back of the throat to treat sleep apnea. He essentially has modified an older technique called a Uvulopalatopharyngoplasty or UP3 and improved the method, which he believes reduces the side effects and improves outcomes. His version of Palatal Reconstructive Surgery is much more minimal to better preserve function. After performing thousands of procedures to treat snorers and sleep apnea patients, Dr. Pasha believes that palatal reconstruction is a much-improved method than traditional approaches. He describes the procedure as a “face lift” for the back of the throat.
Remember the soft palate is the back of the roof of the mouth, which is soft. The “bell” that attaches to the soft palate is called the uvula. The tonsils are the two balls on the sides of the back of the throat and are surrounded by a pocket. The soft palate, uvula, tonsils, and tonsil pocket all make up the snoring center where the sound of snoring originates. When elongated, this is also the area that flaps backward when you sleep, blocking your airway causing apneas.
Dr. Pasha’s modification on Palatal Reconstruction involves several steps:
- Removal of the Tonsils and the Tonsil Pocket: By removing the tonsils (standard tonsillectomy) as well as the tonsil pockets, the sides of the throat are widened. This step may also be performed in people who have already had their tonsils removed (but not removal of the tonsil pocket). Adenoids, which are located behind the nose, may also be removed at the same time.
- Reconstruction of the Sides of the Throat: After removal of the tonsils and tonsil pockets there is an open space. This space is closed in a way to allow for proper healing.
- Removal of part of the Soft Palate: The floppy area of the back of the throat is then removed while preserving as much of the mid-portion and muscle to preserve the function of swallowing and speaking.
- Reconstruction of the Soft Palate: The soft palate is then reconstructed in such a way to allow for healing a preservation of function.
- Reconstruction of the Uvula (Uvuloplasty): Dr. Pasha believes that everything in the body has a purpose including the uvula. According to Dr. Pasha, he believes that the uvula has several functions including “funneling” secretions from the nose down the center of the palate so that you unknowingly swallow it. The uvula may also serve in roles in swallowing and speech.
The last step is that Dr. Pasha will either shorten the uvula or create a “new” uvula using tissue from the soft palate. Often the procedure is performed at the same time with a Genioglossal Advancement Procedure.