Elongated (Long) Uvula Causes, Symptoms and Treatment

Elongation of Uvula

Elongated (Long) Uvula Causes, Symptoms and Treatment

Photo descriptions: A photo showing the inside of a patient's mouth with snoring complaints. It appears that the patient's uvula is quite long and in contact with the tongue root. Uvula may prolong and sag due to many reasons such as snore-induced vibratory trauma, smoking, alcohol use. Uvulopalatal Flap (UPF) was planned for this patient.

Uvula's tasks (functions of uvula)

Uvula is a structure under the soft palate, lying between the tonsils in the midline, with muscle, connective tissue and mucous membranes. There are duties such as preventing the mouth from escaping from the nasal passage and directing the discharge from the nasal passage to the esophagus instead of the trachea. It does not play much role in creating speech and sound as much as our language.

Symptoms of uvula elongation

Some patients may experience uvula lengthening over time. If the uvula is longer than normal and comes in contact with the root of the tongue, the feeling of stuck in the throat, cough, snoring that becomes evident when lying on your back complaints may occur.

In patients with elongated uvula, the following symptoms may occur:

. Sore throat sensation
. Snoring and sleep apnea
. Cough
. Daytime sleepiness
. Decreased sleep quality

The prolongation of the uvula or the presence of mucosal flaps on the uvula  may be the underlying cause in patients with a cough of unknown origin (source: Long uvula: an unusual cause of chronic cough). Link to a publication published with a physician friend from abroad on the subject >> Pedicled Mucosal Flap of the Uvula: An Unusual Cause of Chronic Cough in an Adult

Acute swollen of uvula (uvulitis)

The uvula contacts the food passing through the mouth, that is, products that are hot and which can increase tissue relaxation may cause the uvula to elongate over time. As a separate concept; Various allergic reactions and infections can also cause sudden onset of uvula swelling.

Suddenly swollen of uvula causes

Sometimes uvula can grow suddenly, except for the reasons written in this article. Sudden swelling of the uvula is usually caused by contact with an irritant or allergic product through the network. For example, I had patients who suffered from respiratory distress due to uvula swelling and airway

constriction during the time I was on duty after a misconception of sinusitis “squeezing bitter melon or squeezing donkey cucumber into the nose burun. Again, in the field, after spraying chemical pesticides on the trees, I saw a uvula swell quite seriously in a patient who took his hand to his mouth. Sudden swelling of the uvula may also occur due to infection, aphthae and trauma (source: Swollen Uvula). In hereditary angioneurotic edema, recurrent sudden uvula swelling may also occur (source: Hereditary Angioedema Clinical Presentation). In such cases, avoidance of hot foods and irritant spicy foods, cortisone and the use of antihistaminic drugs is sufficient. Cold foods such as ice cream can sometimes be eaten under doctor control.

Why does uvula elongation?

The reasons for the elongationof the uvula can be summarized as follows:

- Long-term use of alcohol, muscle relaxant, antidepressant and antispychotic drugs that cause tissue relaxation
- "Smoking" with hot smoke causing increased tissue edema
- Increased tissue laxity as a result of keeping the body metabolism at minimum level without any sporting activities (sitting work)
- Weight gain and increased sublingual fat (usually repeated snoring that occurs as a result of vibration trauma, uvula elongation occurs over time)
- Consumption of excessively hot foods may also cause small language elongation over time.

Snoring - how does chronic vibratory trauma cause uvula sagging?

Uvula is located between the tonsils and at the bottom of the soft palate. The snoring complaint is caused by vibratory vibration of the upper airways while breathing and this vibration trauma causes sagging of the uvula and soft palate in time. The longer the uvula grows, the more the snoring sounds, and in fact, the event goes into a vicious circle (the longer the uvula increases, the more the vibratory vibration sounds, the more the complaints of airway stenosis and tired waking also increase). Edema at the tip of the uvula, which is trapped between the large tonsils, is remarkable. Again, due to reasons such as nasal flesh or nasal flesh growth, mouth open sleep; as it prevents the muscles that open the larynx and other air holes; it can also increase the dryness and irritation of the throat and facilitate sagging of the uvula. Usually in the morning when uvula edema is the most. In pediatric patients, tonsil + nasal surgery is usually sufficient for treatment and it can be observed that the uvula is recovering up again over time. In adult patients, multiple airway stenosis, alcohol use, sedentary lifestyle, smoking, irregular sleep, muscle relaxant or psychiatric drugs make treatment difficult.

Why does alcohol cause uvula elongation?

Uvula is in direct contact with edible and smoked products; as it contains muscle tissue, it is also affected by drugs and products that increase tissue relaxation through blood. In other words, alcohol and hot products directly touch the uvula; The use of alcohol can also help ease sagging of the uvula, as it increases tissue relaxation (source: Causes of Swollen After Uvula Alcohol). In chronic use, the vibratory snoring trauma on the loosened uvula increases and over time the uvula extends downward by the effect of gravity. Stopping alcohol use, avoiding muscle relaxants, regular sports such as walking, jogging or swimming and regular life can prevent uvula growth.

Why does smoking cause uvula elongation?

When smoking, the hot-smoked air is vacuumed directly on the uvula and soft palate. When cooking, the meat is thrown into the hot water, it can be seen to first become swollen and then cooked. With the same mechanism, the uvula is actually cooked repeatedly while smoking. If an additional factor such as alcohol use, irregular life, and muscle relaxant use is added, the prolongation of uvula is accelerated (source: Inflammation of the Uvula).

Aging is another reason for the elongation of uvula!

Almost all tissues in our body tend to the ground over time. This is not the only cause of tissue atrophy or loss of elasticity in the tissues. In addition to loss of muscle mass or muscle tone, prolonged uvula may be seen in old age due to many recurrent factors such as uvula contact with hot cigarette smoke, alcohol use, and contact with muscle relaxant products. In the past, elderly patients who did not smoke, snore, did not use alcohol, did sports, did not use muscle relaxants, fed mediterranean style, and whose tonsils were not large may have less uvula elongation.

Treatment of elongated vula

Lifestyle changes - Non-surgical precautions

In patients with uvula elongation, it is recommended to eliminate the causes and increase the sport activities. I would like to summarize below what I frequently recommend to my patients:

. Avoidance of smoking, alcohol, antidepressant drug, muscle relaxant and tissue relaxation drugs
. Having regular sleep hours
. Mediterranean-style nutrition and weight control
. Rhythm, at least 45 minutes and at least 3 days a week walking (sometimes in the park, I do not mean the style of aunt talking and talking calmly, breathing through the nose, giving mouth, opening arms and legs)

Elongated uvula surgical treatment

In addition, in patients with signs of uvula elongation, and sleep apnea syndrome, the patient also added to the picture, classical uvula surgery, uvulalectomy (uvulectomy) surgery, the tip of the uvula, the small portion of the tongue to be folded upward suturing surgery (uvulopalatal flap), only the uvula a knot is cut and shortened by throwing, uvula electrocautery, laser, thermal welding or radiofrequency with the help of cutting process can be done.

Similar links >> Uvulopalatopharyngoplasty (UPPP) Operation - Sleep Apnea and Snoring Surgery / Treatment of Snoring and Sleep Apnea

Simple Uvulectomy Operation Under Local Anesthesia Under Office Conditions

The patient, seen in the photos above and below, was operated under local anesthesia in office conditions. After spraying the patient's mouth containing the local anesthetic lidocaine, local anesthetic was injected into the upper part of the uvula. After the clamp was placed at the bottom of the uvula and tied with a 4/0 vicryl suture, the tip of the uvula above the clamp was cut (uvulectomy operation). Here, only one stitch was used to control bleeding and no burn wound was created. An absorbable suture material is used and the suture falls off completely within 1 week. During this procedure, gag reflexes may be triggered and it may not be easy to perform under local anesthesia in sensitive patients. It can also be performed using different techniques and devices under general anesthesia.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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