[What should we know about uvula doing uvulopalatoplasty]. / Co powinnismy wiedziec na temat jezyczka wykonujac uwulopalatoplastyke.

ABSTRACT

INTRODUCTION: Investigators have been interested in the structure and function of the uvula for centuries. Some of them emphasized its influence on the tone of voice, others its immunological role. Since the times of Hippocrates, people have been afraid of the uvula oedema, as it could lead to apnea and death. It was also suspected that upper airway diseases originated from the uvula. That's why excision of the uvula has been a common practice in folk medicine carried out as a ritual act in the North Africa and Middle East for many centuries up to now. Nowadays Evidence Based Medicine recommends uvulectomy as a part of surgical treatement in any form of sleep related obstructive breathing disorders. The aim of this study was to present the specific function of the uvula and draw the practical conclusions concerning uvulopalatopharyngoplasty. MATERIAL AND METHODS: Histological analysis of the uvula and soft palate samples obtained by UPPP from 37 adults suffering from moderate OSAS was performed. RESULTS: This investigation revealed that the uvula contained significantly more salivary glands with predominant serous type in comparison with the palatine arches tissue. Glandular follicles were composed of the pyramid-shaped epithelial cells lying on the basement membrane. Between these there were myoepithelial cells which pushed serous secretion to the excretory ducts. CONCLUSIONS: Histologically unique structure of the uvula, when compared with other parts of the soft palate, suggests that the uvula plays a very important role in moistening the oropharyngeal mucosa. Since the feeling of dryness in the throat is one of the most frequent complaints after UPPP, the modification of the standard operative technique in order to preserve the uvula, should be considered.