ABSTRACT
The UPPP is not a perfect operation even in those type I candidates where the obstruction is thought to be solely at the soft palate level. Studies using multilevel pressure transducer measurements in patients following UPPP have demonstrated persistent obstruction at the retropalatal level, despite what was thought to be an adequate soft palate resection and oropharynx tightening (5,6). Surgeons vary in the amount of palate they resect based, in part, on concerns over creating long-term post-operative velopharyngeal insufficiency (VPI) with speech and swallowing problems. Variations in UPPP technique have been described by several authors and some appear to produce better results than others. It is difficult to compare different techniques because of differences in patient mix; prospective, randomized trials comparing techniques are needed, such as those performed by Thomas et al. (7) for tongue-base surgery.
