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Respiratory problems in acromegaly

Published online by Cambridge University Press:  29 June 2007

N. J. Murrant*
Affiliation:
London
D. J. Gatland
Affiliation:
London
*
N. J. Murrant, Ear, Nose and Throat Department, St Bartholomew's Hospital, London EC1A 7BE.

Abstract

Death from respiratory causes in acromegaly is three times more common than in the general population and is most often the result of upper airways obstruction, although less commonly pulmonary dysfunction and disturbance of the central nervous system may occur. These factors may be found alone or in combination.

Despite several reports of laryngeal involvement, upper airway obstruction in acromegaly is usually regarded as being due to macroglossia and pharyngeal soft tissue hypertrophy. We present four cases of acromegaly in which tracheostomy was required for laryngeal obstruction, with a review of the literature concerning the nature of respiratory problems in acromegaly.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1990

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References

Barnes, A. J., Pallis, C. and Joplin, G. F. (1979). Acromegaly and narcolepsy. Lancet, 2: 323333.Google ScholarPubMed
Bhatia, M. L., Misra, S. C. and Prakash, J. (1966). Laryngeal manifestations in acromegaly. Journal of Laryngology and Otology, 80: 412417.CrossRefGoogle ScholarPubMed
Brody, J. S., Fisher, A. B., Gocmen, A. and Dubois, A. B. (1970). Acromegalic pneumomegaly: Lung growth in the adult. Journal of Clinical Investigation, 49: 10511060.CrossRefGoogle Scholar
Burn, J. M. B. (1972). Airway difficulties associated with anaesthesia in acromegaly. British Journal of Anaesthesia, 44: 413414.CrossRefGoogle ScholarPubMed
Cadieux, R. J., Kales, A., Santen, R. J., Bixler, E. O. and Gordon, R. (1982). Endoscopic findings in sleep apnea associated with acromegaly. Journal of Clinical Endocrinology and Metabolism, 55: 1822.CrossRefGoogle ScholarPubMed
Cassar, J., McKelvie, P. and Joplin, G. F. (1979). Reversal of laryngeal obstruction following treatment of acromegaly. Journal of Laryngology and Otology, 93: 403404.CrossRefGoogle ScholarPubMed
Chappel, W. F. (1896). A case of acromegaly with laryngeal and pharyngeal symptoms. Journal of Laryngology, Rhinology and Otology, 10: 142.Google Scholar
Dujovny, M., Osgood, C. P. and Segal, R. (1976). Acute acromegalic dyspnoea. Laryngoscope, 86: 13971401.CrossRefGoogle Scholar
Evans, C. C., Hipkin, L. J. and Murray, G. M. (1977). Pulmonary function in acromegaly. Thorax, 32: 322327.CrossRefGoogle ScholarPubMed
Frohman, L. A. (1985). In Cecil Textbook of Medicine, 17th Edition. Edited by Wyngaarden, J. B. and Smith, L. H. WB Saunders and Co., Philadelphia. 12611262.Google Scholar
Gastaut, H., Tassinari, C. A. and Duron, B. (1966). Polygraphic study of the episodic diurnal and noctural (hypnic and respiratory) manifestations of the Pickwickian syndrome. Brain Research, 1: 167186.CrossRefGoogle Scholar
Goldhill, D. R., Dalgleish, J. G. and Lake, R. H. N. (1982). Respiratory problems in acromegaly. Anaesthesia, 37: 12001203.CrossRefGoogle Scholar
Grotting, J. K. and Pemberton, J. de J. (1950). Fixation of the vocal cords in acromegaly. Archives of Otolaryngology, 52: 608617.CrossRefGoogle ScholarPubMed
Guilleminault, C. and Dement, W. C. (editors) (1978). In: Sleep Apnea Syndromes. Alan, R. Liss Inc., New York. 10.Google Scholar
Harrison, B. D. W., Millhouse, K. A., Harrington, M. and Nabarro, J. N. D. (1978). Lung function in acromegaly. Quarterly Journal of Medicine, 47: 517532.Google ScholarPubMed
Hart, T. B., Radow, S. K., Blackard, W. G., Tucker, H. StG. and Cooper, K. R. (1985). Sleep apnea in active acromegaly. Archives of Internal Medicine, 145: 865866.CrossRefGoogle ScholarPubMed
Hassan, S. Z., Matz, G. J., Lawrence, A. M. and Collins, P. A. (1976). Laryngeal stenosis in acromegaly. Anaesthesia and Analgesia, 55: 5760.CrossRefGoogle ScholarPubMed
Jackson, C. (1918). Acromegaly of the larynx. Journal of the American Medical Association, 71: 19871989.Google Scholar
Kitahata, L. M. (1971). Airway diffciculties associated with anaesthesia in acromegaly. British Journal of Anaesthesia, 43: 11871190.CrossRefGoogle ScholarPubMed
Mezon, B. J., West, P., MacLean, J. P. and Kryger, M. H. (1980). Sleep apnea in acromegaly. American Journal of Medicine, 69: 615618.CrossRefGoogle ScholarPubMed
Moorewood, D. J. W., Belchetz, P. E., Evans, C. C. and Whitehouse, G. H. (1986). The extrathoracic airway in acromegaly. Clinical Radiology, 37: 243246.CrossRefGoogle Scholar
Mukhtar, E., Alexander, L., Wilkinson, R., Appleton, D. and Hall, R. (1973). Thyroid function in acromegaly. Lancet, 2: 279283.Google Scholar
Ovassapian, A., Doka, J. C. and Ramsa, D. E. (1981). Acromegaly-Use of the fibreoptic laryngoscope to avoid tracheostomy. Anaesthesiology, 54: 429430.CrossRefGoogle Scholar
Perks, W. H., Horrocks, P. M., Cooper, R. A., Bradbury, S., Allen, A., Baldock, N., Prowse, K. and Van't Hoff, W. (1980). Sleep apnoea in acromegaly. British Medical Journal, 280: 894897.CrossRefGoogle ScholarPubMed
Pickett, J. B. E., Layzer, R. B. and Levin, S. R. (1975). Neuromuscular complications of acromegaly. Neurology, 25: 638645.CrossRefGoogle ScholarPubMed
Rees, P. J., Hay, J.G. and Webb, J. R. (2982). Acute exacerbation of upper airway obstruction in acromegaly. Postgraduate Medical Journal, 58: 429430.CrossRefGoogle Scholar
Romanczuk, B. J., Postic, W. P. and Atkins, J. P. (1978). Hypersomnia with period breathing (an acromegalic Pickwickian). Journal of Otolaryngology, 86: 897903.Google ScholarPubMed
Siegler, J. (1952). Acromegaly associated with laryngeal obstruction. Journal of Lryngology, 66: 620621.CrossRefGoogle ScholarPubMed
Southwick, J. P. and Katz, J. (1979). Unusual airway difficulty in the acromegalic patient—Indications for tracheostomy. Anaesthesiology, 51: 7273.CrossRefGoogle ScholarPubMed
Toppell, K. L., Atkinson, R. and Whitcombe, M. E. (1973). Lung growth in acromegaly. American Review of Respiratory Disease, 108: 12541258.Google ScholarPubMed
Wright, A. D., Hill, D. M., Lowy, C. and Russell-Fraser, T. (1972). Mortality in acromegaly. Quarterly Journal of Medicine, 334: 5158.Google Scholar