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Morphological study of upper airways and long-term follow-up of obstructive sleep apnea syndrome in acromegalic patients
- Source :
- Endocrine. 51:308-316
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- Pathogenesis and long-term outcome of obstructive sleep apnea syndrome (OSAS) in acromegalic patients are still under debate. The aim of the study was to assess the prevalence and long-term follow-up of a series of acromegalic patients with OSAS and to investigate site, degree, and possible causes of upper airway obstruction by morphological study. Cross-sectional and longitudinal study was conducted in 58 acromegalic patients (33 active, 25 controlled) with polysomnography in all subjects, repeated in 25 patients with OSAS, and echocardiography. Morphological study including fiberoptic nasopharyngoscopy with the Muller maneuver (FNMM), magnetic resonance imaging (MRI), with 3-dimensional (3D) elaboration was also performed. The prevalence of OSAS was 58.6 % in the whole series: 63.6 % in the active group and 52 % in the controlled one. Left ventricular hypertrophy was more prevalent in patients with OSAS. OSAS improved in 62.5 % of active patients after achieving hormonal control, whereas it persisted or got worse in 66.6 % of the controlled ones. The uvula and tongue base were the main site of obstruction assessed by FNMM. Uvula diameters obtained by MRI study correlated with the severity of upper airway collapse assessed by FNMM and tongue measure with apnea–hypopnea index (p = 0.044). A greater narrowing and a smaller total volume of upper airways were confirmed by 3D-MRI in patients with more severe OSAS. Uvula and tongue hypertrophy plays a relevant role in the pathogenesis and severity of OSAS. Intensive treatment of acromegaly needs to be promptly adopted in order to reverse it.
- Subjects :
- Adult
Male
Müller's maneuver
medicine.medical_specialty
Polysomnography
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
Pathogenesis
Left ventricular hypertrophy
03 medical and health sciences
0302 clinical medicine
Endocrinology
Tongue
stomatognathic system
Internal medicine
medicine
Humans
Acromegaly, Sleep apnea syndrome, Pathogenesis, IGF-1
Aged
Sleep Apnea, Obstructive
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Middle Aged
Airway obstruction
medicine.disease
Magnetic Resonance Imaging
respiratory tract diseases
Surgery
Obstructive sleep apnea
Sleep apnea syndrome
Cross-Sectional Studies
medicine.anatomical_structure
Uvula
Acromegaly
IGF-1
Cardiology
Pharynx
Female
business
Airway
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15590100 and 1355008X
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Endocrine
- Accession number :
- edsair.doi.dedup.....545c210e099cf2283d5536d33196c307