Management of total nasopharyngeal stenosis following UPPP.

UPPP has emerged over the past decade as a surgical procedure to improve or possibly eliminate Obstructive Sleep Apnea. The procedure itself is not uniformly successful and the technique continues to undergo evolution. Most complications occur in the acute post-operative period and are not unusual. Late complications are seen much less frequently: less than 100 cases of severe nasopharyngeal stenosis have been reported. Several authors have previously identified this problem and have published "avoidance strategies" and we recommend that the UPPP surgeon be well aware of these pitfalls and the ways to avoid them. Stenosis repair using pharyngeal flaps should be the primary technique used to correct this problem. The radial forearm free flap provides the surgeon with another technique for repair of acquired nasopharyngeal stenosis in problem cases in which pharyngeal flap procedures have failed. As with any surgery, the surgeon must have a thorough understanding of the wound healing process.