Velopharyngeal Insufficiency (VPI) After UPPP or Uvula Excision Surgery

Image 1 : Normal open position One of the main risks of uvula excision and UPPP (uvulopalatopharyngoplasty) surgery to treat snoring and obstructive sleep apnea is velopharyngeal insufficiency (VPI). This complication is when the soft palate is not able to adequately lift and close off the back of the nose from the throat.  When the VPI is large, food and liquids can come out the nose during swallow and there may be a hyper-nasal speech quality. When the VPI is very small, a patient ma…

6/10/2016 0

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Surgeon Scorecard - Good or Bad?

There has been a media frenzy regarding ProPublica's Surgeon Scorecard which rates how "good" a surgeon is based on calculated death and complication rates for surgeons performing one of eight elective procedures. Unfortunately, a surgeon paradox will develop where one may actually WANT the surgeon with the WORST score because a surgeon with the BEST score refuses to operate on a high-risk patient. Why? Although great in concept, the Surgeon Scorecard introduces the law of u…

8/13/2015 0

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Types of Ear Tubes

Ear tubes are placed whenever adequate ventilation of the middle ear is compromised and unresponsive to medications. Such situations include chronic ear infections , eustachian tube dysfunction , hearing loss due to fluid, etc. Once the decision is made to place an ear tube, the surgeon has many choices of ear tubes that could be placed. There are three main "classes" of ear tubes: grommet tubes (A), intermediate tubes (B), and T-tubes (C). When selecting what class of tube to pl…

6/06/2015 0

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Surgeries on a Weekend Have More Complications

The New York Times published an interesting story regarding how patients with ulcerative colitis suffered significantly more surgical complications when performed on a weekend compared to a weekday. Just how much worse? The cited  research  reported that the most common post-operative complication was post-operative infections (Weekend 30% vs. Weekday 20%). However, there was also an increased risk of need for repeat laparotomy, mechanical wound complications, and pulmonary complications…

3/22/2013 0

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Sleep Apnea Surgery Malpractice Lawsuit

In November 2009, a patient underwent multi-level surgery to treat her mild-moderate obstructive sleep apnea by a Houston, TX otolaryngologist. The surgery included: • Uvulopalatopharyngoplasty (UPPP) • Tonsillectomy (typically considered part of UPPP) • Adenoidectomy • Hyoid Myotomy • Genioglossus Advancement She unfortunately experienced some unspecified complications stemming from this surgery which apparently has not helped with her obstructive sleep apnea either. A malpractic…

1/24/2012 2

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