Uvulopalatopharyngoplasty (UPPP)

ʻO Uvulopalatopharyngoplasty (UPPP) kahi ʻoki e wehe i nā alaloa kiʻekiʻe ma o ka lawe ʻana i nā kiko keu i ka puʻu. Hana ʻia paha ia e mālama i ka mea hōʻoluʻolu o ka hiamoe (OSA) a i ʻole ka ʻūlū nui ʻana.

Wehe ʻo UPPP i nā mea palupalu ma hope o ka puʻu. Pākuʻi ʻia kēia:

• ʻO nā āpau a ʻāpana paha o ka uvula (ka pale palupalu o nā mea i kau ʻia ma ka hope o ka waha).
• ʻO nā ʻāpana o ka pā palu a me nā mea ma nā ʻaoʻao o ka puʻu.
• Tonsils a me adenoids, inā aia mau lākou.

Hiki i kāu kauka ke koi aku i kēia ʻoki inā loaʻa ʻoe i kahi kahawai hiamoe ākea ākea (OSA).

• E hoʻāʻo e hoʻololi i ka nohona ma mua, e like me ka pohō kaumaha a hoʻololi paha i kou kūlana hiamoe.
• Paipai ka hapanui o ka poʻe loea i ka hoʻāʻo ʻana e hoʻohana i ka CPAP, nā ihu e hoʻonui ana i ka ihu, a i ʻole he hāmeʻa waha e mālama mua iā OSA.

Koi paha kāu kauka i kēia ʻoki e mālama i ka snoring koʻikoʻi, ʻoiai inā ʻaʻohe ou OSA. Ma mua o kou hoʻoholo ʻana no kēia ʻoki kino:

• E ʻike inā kōkua ke kaupaona ʻana i kou hū ʻana.
• E noʻonoʻo pehea ka mea nui iā ʻoe e mālama i ka ʻūlū. ʻAʻole holo ka ʻoki no kēlā me kēia kanaka.
• E hōʻoia e uku kāu ʻinikua no kēia ʻoki kino. Inā ʻaʻohe ou OSA, ʻaʻole uhi paha kāu ʻinikua i ke ʻoki.

I kekahi manawa, hana ʻia ʻo UPPP me nā ʻoki hou hou aʻe e mālama ai i ka OSA koʻikoʻi.

Nā pilikia no ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau a i ʻole nā ​​pilikia hanu
• Kahe ʻana o ke kahe, ke koko koko, a i ʻole ka maʻi

ʻO nā pilikia no kēia ʻoki kino penei:

• Poino i nā mākala i ka ʻāʻī a me ka palahalaha palupalu. Loaʻa paha iā ʻoe kekahi mau pilikia i ka mālama ʻana i nā wai mai ka puka ʻana mai o kou ihu ke inu ʻoe (i kapa ʻia ka lawa ʻole o ka velopharyngeal). ʻO ka pinepine, he hopena manawa pōkole wale nō kēia.
• Mucus i ka ʻāʻī.
• Hoʻololi haʻi ʻōlelo.
• Make wai.

E ʻōlelo pono i kāu kauka a kahu maʻi paha:

• Inā ʻoe a hāpai paha
• He aha nā lāʻau āu e lawe nei, e like me nā lāʻau, nā mea hoʻopili, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau
• Inā inu nui ʻoe i ka waiʻona, ʻoi aku ma mua o 1 a 2 paha inu i ka lā

I nā lā ma mua o ke kaha ʻana:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā mea lahilahi e like me aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• E nīnau i kāu kauka i nā lāʻau e pono ai ʻoe e lawe i ka lā o kou ʻoki ʻana.
• Inā puhi ʻoe, hoʻāʻo e kū. Hiki i ka puhihihi ke hoʻolohi i ka hoʻōla. E noi i kāu mea nāna e hāʻawi i ke kōkua no ka haʻalele.
• E hoʻomaopopo i kāu mea hāʻawi e pili ana i kekahi anuanu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe āu e loaʻa ai ma mua o kāu ʻoki. Inā maʻi ʻoe, pono e hoʻopaneʻe ʻia kāu ʻoki kino.

I ka lā o ke kaha:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai i kekahi mea no kekahi mau hola ma mua o ke ʻoki.
• E lawe i nā lāʻau a kou kauka i ʻōlelo ai iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hāhai i nā ʻōkuhi i ka hiki ʻana i ka haukapila. E hōʻea pono i ka manawa.

Pono kēia ʻoki pinepine i ka noho pō ʻana i ka haukapila e ʻike pono hiki iā ʻoe ke ale. Hiki ke hōʻeha ke kahakaha ʻo UPPP a he 2 a 3 mau pule paha ke ola piha.

• E ʻeha loa kou ʻāʻī a hala i mau pule. E loaʻa iā ʻoe nā lāʻau ʻeha ʻino e hoʻonā i ka ʻeha.
• He mau humuhumu paha kāu ma ka hope o kou puʻu. E hoʻopau kēia mau mea a i ʻole lawe aku kāu kauka iā lākou i ka kipa mua ʻana.
• E ʻai wale i nā meaʻai palupalu a me nā wai no nā pule he 2 ma hope o ke kaha ʻana. Hōʻalo i nā meaʻai crunchy a i ʻole nā ​​meaʻai paʻakikī e mama.
• Pono ʻoe e holoi i kou waha ma hope o ka ʻai ʻana me kahi wai paʻakai no 7 a 10 mau lā mua.
• Hōʻalo i ka hāpai hāpai ʻana a i ʻole ke kānana ʻana no nā pule 2 mua. Hele paha ʻoe a hana i ka hana māmā ma hope o 24 mau hola.
• E kipa hele aku ʻoe me kāu kauka 2 a i ʻole 3 mau pule ma hope o ke kaha ʻana.

Hoʻomaikaʻi mua ka hiamoe no ka hapalua o ka poʻe i loaʻa i kēia ʻoki. Ke holo nei ka manawa, pau ka pōmaikaʻi no nā poʻe he nui.

Hōʻike kekahi mau noiʻi he kūpono kūpono loa ke kaha ʻana no ka poʻe me nā ʻano ʻē ma ka palahalaha.

ʻOki kino Palate; Nā kaʻina hana Uvulopalatal; UPPP; Uvulopalaplasty i kōkua ʻia e ka Laser; Palatoplasty Radiofrequency; Ka lawa ʻole o Velopharyngeal - UPPP; Apena moe hiamoe - uvulopalaplasty; OSA - uvulopalaplasty

ʻO Katsantonis GP. Uvulopalatopharyngoplasty kahiko. I: Friedman M, Jacobowitz O, eds. ʻO ka Apne Moe a me ka Honi. ʻElua ed. Piladelapia, PA: Elsevier; 2020: chap 32.

ʻO Qaseem A, Holty JE, Owens DK, et al; ʻO ke Kōmike Alakaʻi Clinical o ke Kulanui ʻAmelika o nā Kauka. Ka mālama ʻana i ka apnea moe pōpilikia i nā mākua: kahi kulekele hana hoʻokolohua mai ke Kulanui ʻAmelika o nā Kauka. ʻO Ann Intern Med. 2013; 159 (7): 471-483. PMID: 24061345 www.ncbi.nlm.nih.gov/pubmed/24061345.

ʻO Wakefield TL, ʻo Lam DJ, ʻo Ishman SL. ʻO ka maʻi hiamoe a me nā maʻi hiamoe. I: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ke poʻo poʻo a me ka ʻāʻī. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2015: chap 18.