Cautery-Assisted Palatal Stiffening Operation (CAPSO)

Our goal is to inform you of what you can expect before and after surgery and how to best care for yourself at home. We believe that having as much information as possible prior to surgery will help you feel confident before surgery as well as when you go home.

1. 1. General Information for Patients
      1. You will have pain at the roof of your mouth for 7 to 14 days after the operation. Your most severe pain will generally occur on postoperative days 3 through 5. Please refer to this handout for pain control regimen.
      2. You will need about 1 week off from work.
      3. During the first 10 days, swallowing may be painful, but speech is not usually affected.
      4. The roof of your mouth will look red and swollen with grey and yellowish-white areas that will gradually dissolve away. Your pain will decrease when red tissue begins to appear where the yellow-white area had been
      5. You may have a sensation like gauze in the back of your mouth. This is temporary and resolves with healing.
      6. Your breath may smell unpleasant for 2 week after your operation. Nonalcoholic mouthwashes (e.g., Plax or Act) can be used. Gentle brushing of teeth with small amounts of toothpaste is recommended.
      7. It is common to experience ear pain as the roof of your mouth heals. This is called “referred pain” as the eustachian tubes are connected to the palatal muscles.
      8. Secretions in the back of the throat can be bothersome during the healing period. Sleeping with your head elevated on pillows may be helpful.
      9. Your snoring will not start to improve until 3 to 4 weeks after your operation. The palate must scar and stiffen over this time period before snoring diminishes.
   2. Diet and Fluids
      1. It is important to stay well hydrated by drinking increased amounts of fluids.
      2. A soft bland diet that is neither hot nor cold will be easier to swallow. Your palate will be sensitive to temperature extremes.
      3. It is a good idea to stock your shelves with some of the following items before surgery so they will be available to you upon your return home after surgery:

1. Activity
   1. After your surgery, it is important for you to maintain as normal a lifestyle as before surgery.
   2. The medication regimen will help you control your pain so you can sleep at night and stay awake during the day.
   3. It is very important to keep your days “days” and your nights “nights!” Altering your sleep cycle may increase pain perception.
2. For General Practitioners
   1. The operation involves removal of an area of mucosa from the midline surface of the soft palate.
   2. The postoperative wound is similar to that of a tonsillectomy. However, it is in the center of the palate rather than the side wall of the pharynx.
   3. Postoperative antibiotics or steroids are generally not given as these may diminish the desired palatal scarring/stiffening. If there are any problems or questions, please contact our office at 240 361-9000.

Cautery-Assisted Palatal Stiffening Operation (CAPSO) Pain Control Regimen

As you know, the operation is painful, and this regimen has been designed to help as much as possible. The pain usually begins the day after surgery and may last for as long as two weeks. It is usually more severe at night and at mealtimes. It is important to remember that meals can be skipped, but hydration is a must. Continue to drink plenty of fluids no matter how uncomfortable you may be.

Medications

1. Green Cepacol Lozenges (purchase at any drug store)
   Suck 1 every hour as needed.
2. Tylenol – 500 mg tablets
   Take 1 or 2 tablets every four hours as needed for pain.
3. Tylenol #3
   Substitute 1 or 2 tablets for regular Tylenol every 4 hours as needed for severe pain.
4. Aspirin rinses (dissolve 80 aspirin in a one liter bottle of water)
   Shake bottle, rinse with 2 tablespoons of solution, and spit (do not gargle) every 30 minutes to an hour as needed.

Before Meals

1. Suck 1 Cepacol.
2. Rinse and spit with aspirin rinse.

At Bedtime

1. Suck 1 Cepacol.
2. Rinse and spit with aspirin rinse.
3. Take 1 or 2 Tylenol #3.
4. A cool mist vaporizer in the bedroom at night will help keep the palate moist while sleeping. An overly dry palate intensifies the pain.

Notes

1. The maximum dose of Tylenol is 1000 mg. every 4-6 hours or 4000 mg per day (this means either 2 Tylenol OR 2 Tylenol #3 every 6 hours – not both).
2. The aspirin rinses must be spit out or an aspirin overdose could occur.
3. Codeine is a narcotic. Do not drive while taking this medicine. Do not mix with alcohol.