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Uvulectomies and Associated Complications

Rebecca Jacobson, MST; Barry Ladizinski, MD; Kachiu C. Lee, MD
JAMA Dermatol. 2013;149(1):32. doi:10.1001/jamadermatol.2013.1128.
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Traditional uvulectomies are common therapeutic or ritualistic procedures that are performed in various countries throughout Africa and the Middle East.1 They have been traced back to Hippocrates (460-355), Galen (129-200), 11th century Spain, and 19th century England and France, where they were used to cure stuttering.2

In the Huasa-speaking communities of Nigeria and Niger, ritualistic uvulectomy is performed as part of a Muslim naming ceremony on the seventh day after birth. This ritual is thought to prevent death from swelling of the uvula, which could burst and kill the neonate.3 In fact, uvula in Huasa means throat herb in Niger, and it is believed that the uvula should be cut prophylactically, just like weeds in the field. These ritualistic uvulectomies are usually performed by an apprenticed barber-surgeon, who identifies a diseased uvula by looking for a finger imprint after pressing on the child's forehead or by identifying a swollen, red, white, or long uvula. The barber then recites verses from the Koran and an inaudible prayer that is thought to protect the child and to guide the barber. The uvula is completely or partially excised using a sickle-shaped knife. Hemostasis is obtained with herbal powders. The uvula is then placed on the forehead of the child and later hangs on the wall in his or her home.2 During the ritual, the child's head is shaved, and a hymenectomy or circumcision may also be performed.2,3 Other variations of the practice include using a reed fork in Morocco, twisted strands of horsehair in Ethiopia, and a hot knife in Egypt.2

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