Morphological study of upper airways and long-term follow-up of obstructive sleep apnea syndrome in acromegalic patients
| Autor: | Giuseppe Francia, Cinzia Castellani, Roberto Cerini, Lorenzo Trevisiol, Maria Vittoria Davì, Luca Dalle Carbonare, Elena Viva, Alessandro Zaccarella, Marcello Ferrari |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
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 |
| Zdroj: | Endocrine. 51:308-316 |
| ISSN: | 1559-0100 1355-008X |
| DOI: | 10.1007/s12020-015-0659-x |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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