Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T12:38:56.473Z Has data issue: false hasContentIssue false
  • English
  • Français

‘A good shepherd, but with obstructive sleep apnoea syndrome’: traditional uvulectomy case series and literature review

Published online by Cambridge University Press:  07 July 2011

M J L Ravesloot  and
N de Vries
M J L Ravesloot*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, St Lucas Andreas Hospital, Amsterdam, The Netherlands
N de Vries
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, St Lucas Andreas Hospital, Amsterdam, The Netherlands
*
Address for correspondence: Dr M J L Ravesloot, Department of Otorhinolaryngology, Head and Neck Surgery, St Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands Fax: +31 (0)20 6899126 E-mail: m.ravesloot@slaz.nl
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In the West, removal of the uvula is predominantly undertaken as part of palatal surgery, in cases of obstructive sleep apnoea. In the developing world, such as the Middle East and Africa, uvulectomy is a more common practice. The uvula is removed for curative or preventive purposes, or as part of ritual practice. Due to immigration from developing to developed world countries, and to Western doctors working abroad, such doctors are increasingly being confronted with unfamiliar traditional healing practices, within a medical context.

Methods:

The Medline and Embase online databases were systematically searched for literature on traditional uvulectomy. We present a review of this literature. We also present the first report, to our best knowledge, of obstructive sleep apnoea as a late complication of traditional uvulectomy.

Discussion:

Traditional uvulectomy may be complicated by post-operative haemorrhage and local infections, among many other problems. We report cases of obstructive sleep apnoea and snoring caused by palatal stenosis resulting from traditional uvulectomy during childhood.

Keywords

Sleep Apnoea, ObstructiveMedicine, TraditionalUvulaUvula, SurgeryPalate, AbnormalitiesNasopharynx, Abnormalities
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 9 , September 2011 , pp. 982 - 986
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Balcerzak, J, Gornicka, B, Karchier, E. What should we know about uvula doing uvulopalatoplasty [in Polish]. Otolaryngol Pol 2006;60:879–82, PMID: 17357666Google ScholarPubMed
2Back, GW, Nadig, S, Uppal, S, Coatesworth, AP. Why do we have a uvula?: literature review and a new theory. Clin Otolaryngol Allied Sci 2004;29:689–93CrossRefGoogle Scholar
3Hunter, L. Uvulectomy – the making of a ritual. S Afr Med J 1995;85:901–2Google ScholarPubMed
4Ijaduola, GT. Uvulectomy in Nigeria. J Laryngol Otol 2004;95:1127–33CrossRefGoogle Scholar
5Hörmann, K, Verse, T. Surgery for Sleep Disordered Breathing. Berlin, Heidelberg: Springer Verlag, 2010;39–128CrossRefGoogle Scholar
6Lowe, KR. Severe anemia following uvulectomy in Kenya. Mil Med 2004;169:712CrossRefGoogle ScholarPubMed
7Beverley, D, Henderson, C. A cross-sectional survey of the growth and nutrition of the Bedouin of the South Sinai Peninsula. Ann Trop Paediatr 2003;23:209–14CrossRefGoogle ScholarPubMed
8Miles, SH, Ololo, H. Traditional surgeons in sub-Saharan Africa: images from south Sudan. Int J STD AIDS 2003;14:505–8CrossRefGoogle ScholarPubMed
9Asefa, M, Hewison, J, Drewett, R. Traditional nutritional and surgical practices and their effects on the growth of infants in south-west Ethiopia. Paediatr Perinat Epidemiol 1998;12:182–98CrossRefGoogle ScholarPubMed
10Hodes, R. Cross-cultural medicine and diverse health beliefs. Ethiopians abroad. West J Med 1997;166:29–36Google ScholarPubMed
11Zamir, C, Zamir, D, Rishpon, D. Traditional practices among children of Ethiopian immigrants in Israel. Ambulatory Child Health 1999;5:351–6Google Scholar
12Prual, A, Gamatie, Y, Djakounda, M, Huguet, D. Traditional uvulectomy in Niger: a public health problem? Soc Sci Med 1994;39:1077–82CrossRefGoogle Scholar
13Einterz, EM, Einterz, RM, Bates, ME. Traditional uvulectomy in northern Cameroon. Lancet 1994;343:1644CrossRefGoogle ScholarPubMed
14Hartley, BE, Rowe-Jones, J. Uvulectomy to prevent throat infections. J Laryngol Otol 1994;108:65–6CrossRefGoogle ScholarPubMed
15Eregie, CO. Uvulectomy as an epidemiological factor in neonatal tetanus mortality: observations from a cluster survey. West Afr J Med 1994;13:56–8, PMID: 8080834Google ScholarPubMed
16Abdullah, MA. Traditional practices and other socio-cultural factors affecting the health of children in Saudi Arabia. Ann Trop Paediatr 1993;13:227–32CrossRefGoogle ScholarPubMed
17Alabi, EM. Cultural practices in Nigeria. Newsl Inter Afr Comm Tradit Pract Affect Health Women Child 1990;9:6–7, PMID: 12157983Google Scholar
18Dagnew, MB, Damena, M. Traditional child health practices in communities in north-west Ethiopia. Trop Doct 1990;20:40–1CrossRefGoogle ScholarPubMed
19Schneider, P, Shewangizaw, E, Tayé, E, Gebrehiwot, T, Worku, S, Oppermann, J et al. Traditional medicine in Ethiopia in childhood diseases [in German]. Kinderarztl Prax 1989;57:393–9, PMID: 2796127Google ScholarPubMed
20Barakat, AY, Itani, U, Zaytoun, GM. Cultural “iatrogenic” cleft palate. Pediatrics 1986;78:511CrossRefGoogle ScholarPubMed
21Dutch National Public Health Atlas. In: http://www.rivm.nl/vtv/object_map/o3169n40160.html [16 January 2011]Google Scholar
22Ijaduola, TG. Acute otalgia in Nigerian children. Trop Geogr Med 1985;37:343–4, PMID: 4095773Google ScholarPubMed
23Manni, JJ. Uvulectomy, a traditional surgical procedure in Tanzania. Ann Trop Med Parasitol 1984;78:49–53CrossRefGoogle ScholarPubMed
24Wind, J. Cross-cultural and anthropobiological reflections on African uvulectomy. Lancet 1984;ii:1267–8Google Scholar
25Nathan, H, Hershkovitz, I, Arensburg, B, Kobyliansky, Y, Goldschmidt-Nathan, M. Mutilation of the Uvula among Bedouins of the South Sinai. Isr J Med Sci 1982;18:774–8Google ScholarPubMed
26Johnston, NL, Riordan, PJ. Tooth follicle extirpation and uvulectomy. Aust Dent J 2005;50:267–72CrossRefGoogle ScholarPubMed
27Nalin, DR. Death of child submitted to uvulectomy for diarrhoea. Lancet 1985;i:643CrossRefGoogle Scholar
28Manni, JJ. Uvulectomy: a surgical procedure within the traditional medicine of Tanzania [in Dutch]. Ned Tijdschr Geneeskd 1982;126:1678–81Google ScholarPubMed
29Fleischer, NK. A study of traditional practices and early childhood anaemia northern Nigeria. Trans R Soc Trop Med Hyg 1975;69:198–200, PMID: 1166490CrossRefGoogle ScholarPubMed
30Coatesworth, AP, Addis, RJ, Beverley, DW. Ear nose and throat diseases in the Bedouin of the South Sinai Desert: a cross-sectional survey and discussion of healthcare needs. J Laryngol Otol 2002;116:83–6CrossRefGoogle Scholar
31Einterz, EM. Family planning and tradition: a view from northern Cameroon. World Health Forum 1994;15:378–81Google ScholarPubMed
32Bourrel, P. Problems related to African customs and ritual mutilations [in French]. Contracept Fertil Sex (Paris) 1983;11:1351–8Google ScholarPubMed
33Wan, DC, Kumar, A, Head, CS, Katchikian, H, Bradley, JP. Amelioration of acquired nasopharyngeal stenosis, with bilateral Z-pharyngoplasty. Ann Plast Surg 2010;64:747–50CrossRefGoogle ScholarPubMed
34Friedman, M, Duggal, P, Joseph, NJ. Revision uvulopalatoplasty by Z-palatoplasty. Otolaryngol Head Neck Surg 2007;136:638–43CrossRefGoogle ScholarPubMed
35Friedman, M, Ibrahim, HZ, Vidyasagar, R, Pomeranz, J, Joseph, NJ. Z-palatoplasty (ZPP): a technique for patients without tonsils. Otolaryngol Head Neck Surg 2004;131:89–100CrossRefGoogle ScholarPubMed
36Krespi, YP, Kacker, A. Management of nasopharyngeal stenosis after uvulopalatoplasty. Otolaryngol Head Neck Surg 2000;123:692–5CrossRefGoogle ScholarPubMed
37Lehmann, WB, Pope, TH Jr, Hudson, WR. Nasopharyngeal stenosis. Laryngoscope 1968;78:371–85CrossRefGoogle ScholarPubMed
38Baptista, P, Carlos, GV, Salvinelli, F, Ponz-Sarvise, M, Casale, M. Acquired nasopharyngeal stenosis: surgical treatment for this unusual complication after chemoradiation for nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 2007;137:959–61CrossRefGoogle ScholarPubMed
39Jones, LM, Guillory, VL, Mair, EA. Total nasopharyngeal stenosis: treatment with laser excision, nasopharyngeal obturators, and topical mitomycin-c. Otolaryngol Head Neck Surg 2005;133:795–8CrossRefGoogle ScholarPubMed
40Hörmann, K, Verse, T. Surgery for Sleep Disordered Breathing. Berlin, Heidelberg: Springer-Verlag, 2010;6CrossRefGoogle Scholar
41Osujih, M. Exploration of the frontiers of tradomedical practices: basis for development of alternative medical healthcare services in developing countries. J R Soc Health 1993;113:190–4, PMID: 11827577CrossRefGoogle ScholarPubMed