What is a Uvulectomy?

Anatomy of the mouth
Anatomy of the mouth. Stocktrek Images/Getty Images

A uvulectomy is a surgical procedure in which all or part of the uvula is removed. The uvula is a bell-shaped organ that hangs from the top of the throat. There are a few different reasons a uvulectomy is performed including some rituals, but most are controversial. The uvula plays a small function in keeping the mouth moist, as it contains many salivary glands. It also plays a role in how we are able to articulate.

However you most likely will not suffer from xerostomia (dry mouth) or be unable to articulate clearly after having a uvulectomy.

Should I Have A Uvulectomy?

While it has not been proven totally effective, perhaps the most common reason for a uvulectomy in the United States is to assist in the treatment of obstructive sleep apnea. A uvulectomy may be performed alone or as part of a larger procedure called a uvulopalatopharyngoplasty (UPPP). The purpose of both procedures is to remove tissue that may be blocking the airway.

Hereditary angioneurotic edema (HANE) is another condition that a uvulectomy is sometimes used to treat. HANE is a rare disease in which the tissues fills with water. If the tissues in and around the throat become too swollen, a person with this condition can suffocate. The idea behind removing the extra tissue of the uvula is that this frees up more space and can prevent asphyxiation.

Other than for obstructive sleep apnea and HANE, a uvulectomy is uncommon in the western world and is more commonly practiced in African and Middle Eastern countries.

What Will Happen During My Uvulectomy?

You do not need to be "put to sleep", or anesthetized, for a uvulectomy. This surgery can be done with local anesthetics to numb the area around your uvula.

After you have had time to sufficiently desensitize the area, your surgeon will likely use either a laser-ablation technique or a hot snare approach. Your surgeon will either perform a low (very little of the uvula is removed), middle (half of the uvula is removed), or high (complete removal) uvulectomy. Following the procedure, you will only need to be observed for about 15 minutes after the procedure and should not have any significant pain or bleeding with either approach.

Prior to going home following a uvulectomy, you will be prescribed an antibiotic and some pain medicine. If you should experience severe pain you should return to your surgeon or go to the emergency department. If significant bleeding occurs go immediately to the emergency department. Minor amounts of bleeding can be dealt with by your surgeon, however post-operative bleeding after a uvulectomy is rare.

Ritualistic Uvulectomies

In some African and Middle Eastern countries, there are ritualistic reasons for having uvulectomies performed, particularly in children.

In Nigeria and Niger, the Hausa believe that the uvula places newborn babies at risk for dying from a swollen uvula. To prevent this from occurring, it is common to have the uvula removed by 7 days after birth. The barber-surgeon identifies whether the ritual should be performed by looking at the uvula for redness, seeing if it is swollen, or looking for a finger imprint after pressing on the forehead. The ritualistic practice includes:

  1. reciting of the Koran before removing the uvula
  2. removing the uvula with a sickle-shaped knife
  3. using herbal powders to stop the bleeding
  4. placing the uvula on the forehead of the child (and then later hanging the uvula in the home)
  5. shaving the head of the child

In some countries, variations to this practice may also include a hymenectomy, circumcision, and replacement of the sickle-shaped knife with another ritualistic tool (reed-fork, horsehair, or a hot knife). The Sinai Bedouins of Egypt and the Ethiopians also believe that their children will be more tolerant of thirst in the desert by performing the ritual. Some other reasons for performing a ritualistic uvulectomy include:

Risks Associated With A Uvulectomy?

Risks with modern uvulectomies are minimal. However pain, bleeding, and infections are possible risks. Ritualistic uvulectomies however carry several risk factors due to technique and sanitary conditions of the surgical instruments. Ritualistic uvulectomies stand a much greater chance at having an infection or bleeding after the removal of your uvula.

Sources:

Aetna. Clinical Policy Bulletin: Obstructive Sleep Apnea in Adults. Accessed: August 20, 2010 from http://www.aetna.com/cpb/medical/data/1_99/0004.html

Friedman, M. (2009). Sleep Apnea and Snoring: Surgical and Non-Surgical Therapy. Saunders: Elsevier.

Jacobson, R., Ladizinski, B & Lee, K.C. (2013). Uvulectomies and Associated Complications. JAMA Dermatol. 2013;149(1):32. doi:10.1001/jamadermatol.2013.1128

Medscape Nurses. Hereditary Angioneurotic Edema Treated by Partial Uvulectomy. Accessed: August 20, 2010 from http://www.medscape.com/medline/abstract/933414

Ravesloot, M.J. & de Vries, N. (2011). 'A good shepherd, but with obstructive sleep apnoea syndrome': traditional uvulectomy case series and literature review. J Laryngol Otol. 125(9):982-6. doi: 10.1017/S0022215111001526

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