I’ve been asked to do a tute on Uvula swelling, and it actually suits me to do this now, because I’m away from home and my books, and this is something I can do while sitting on the beach.
The Uvula is the dangly conical bit sitting in the middle of your throat when you look in the mirror with your mouth open,and it is attached to the soft palate.It is postulated that the Uvula plays a role in the articulation of voice, and it is able to produce large amounts of saliva.Histologically, the Uvula consists of a core of sceletal muscle layers embedded in lose connective tissue, that contains mixed and mucous glands including large ducts interspersed with lymphatic tissue.So, a muscle part that helps with speech, some glands to produce saliva, and some immune system tissue that gets busy during infections, that’s the Uvula in a nutshell.Here’s an overview of the structures of the mouth and throat :
The relevance of conditions of the Uvula is, that it’s part of our airway, which means air we humans inhale to get into our lungs has to pass by the Uvula, whether it’s a nose-breathing infant or you and me.So any condition causing swelling of the Uvula can get you into trouble and potentially compromise your airway.
I can think of 3 major causes for swelling of the Uvula, and it would go beyond the scope of this tute to go into all of them , but generally speaking, those 3 main groups are infection, allergy or angiooedema, and mechanical irritation(for example from snoring in sleepa apnoea).
I should probably mention that the Uvula can also give us a hint that there is something wrong in other parts of the throat and neck, for example by not sitting in the middle but deviating to one side.This can be a sign of an abscess or inflammatory process in the soft tissues of the neck to either side, and is something to look out for.
So what does a swollen Uvula do in terms of clinical symptoms ? Well, based on what we’ve learned about its function, we can guess what symptoms to expect : Possibly a change in articulation of speech, difficulty or pain swallowing or clearing saliva, a general “sore throat” feeling, and in severe cases shortness of breath, noisy breathing(stridor), difficulty breathing while lying flat, or even when sitting up.
Any breathing trouble coming from swelling of the Uvula is a medical emergency, and what we do in Hospital is aimed at reducing the swelling, by giving nebulised Adrenaline(Epinephrine), intravenous Cortisone, and anti-allergy drugs if allergy is suspected, or antibiotics if infection is suspected.We would then watch the patient for 6-12 hours to make sure the problem doesn’t recur.
Mechanical irritation of the Uvula most often stems from the tongue falling backwards in patients with obstructive sleep apnoea syndrome, and can cause an acute swollen Uvula that we have to treat as described above, but also a chronic fibrotic remodeling of the Uvula, which can become more enlarged and stiff with time.The treatment for this might have to be trimming or removal of the Uvula(together with the tonsils if you still have them), but usually sleeping with a mask that supplies continuous positive pressure down your airway(CPAP)is the first step, before any surgery is considered.
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