Xiaopeng Guo1, Lu Gao2, Ya'nan Zhao3, Man Wang3, Bo Jiang3, Qiang Wang2, Zihao Wang2, Xiaohai Liu2, Ming Feng2, Renzhi Wang2, Zhuhua Zhang4, Bing Xing5. 1. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China; China Pituitary Disease Registry Centre, Chinese Pituitary Adenoma Cooperative Group, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. Electronic address: guoxiaopeng_pumch@163.com. 2. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China; China Pituitary Disease Registry Centre, Chinese Pituitary Adenoma Cooperative Group, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. 3. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. 4. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. Electronic address: 15010147685@163.com. 5. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China; China Pituitary Disease Registry Centre, Chinese Pituitary Adenoma Cooperative Group, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. Electronic address: xingbingemail@aliyun.com.
Abstract
OBJECTIVE: To explore the radiological characteristics of the upper respiratory tract and their correlations with obstructive sleep apnoea/hypopnea syndrome (OSAHS) in patients with acromegaly. METHODS: Computed tomography (CT) and magnetic resonance imaging (MRI) were performed in untreated patients with acromegaly placed in straight (SHP) and extended head positions (EHP). Overnight polysomnography was performed to evaluate OSAHS, and the apnoea/hypopnea index (AHI) was measured. RESULTS: According to the CT findings, a thicker soft palate (1.24 ± 0.22 vs. 1.03 ± 0.22 cm, p = 0.024), larger soft palate cross-sectional area (5.15 ± 1.21 vs. 4.06 ± 1.09 cm2, p = 0.027), and thicker lateral pharyngeal wall (1.01 ± 0.25 vs. 0.79 ± 0.14 cm, p = 0.015) were observed in patients with acromegaly who presented with OSAHS compared with patients without OSAHS. Additionally, the maximal transverse diameter (1.87 ± 0.40 vs. 2.31 ± 0.44 cm, p = 0.015) and cross-sectional area (1.98 ± 0.46 vs. 2.74 ± 1.01 cm2, p = 0.032) of the airway were decreased in the soft palate plane in patients with OSAHS. The AHI was positively correlated with the thickness of the soft palate and lateral pharyngeal wall but negatively correlated with the maximal transverse diameter and cross-sectional area of the airway in the soft palate plane. CONCLUSIONS: Airway stenosis and pharyngeal tissue hypertrophy are typical characteristics of changes in the structure of the upper respiratory tract in patients with acromegaly who present with OSAHS. AHI is a predictor of the severity of the respiratory tract changes.
OBJECTIVE: To explore the radiological characteristics of the upper respiratory tract and their correlations with obstructive sleep apnoea/hypopnea syndrome (OSAHS) in patients with acromegaly. METHODS: Computed tomography (CT) and magnetic resonance imaging (MRI) were performed in untreated patients with acromegaly placed in straight (SHP) and extended head positions (EHP). Overnight polysomnography was performed to evaluate OSAHS, and the apnoea/hypopnea index (AHI) was measured. RESULTS: According to the CT findings, a thicker soft palate (1.24 ± 0.22 vs. 1.03 ± 0.22 cm, p = 0.024), larger soft palate cross-sectional area (5.15 ± 1.21 vs. 4.06 ± 1.09 cm2, p = 0.027), and thicker lateral pharyngeal wall (1.01 ± 0.25 vs. 0.79 ± 0.14 cm, p = 0.015) were observed in patients with acromegaly who presented with OSAHS compared with patients without OSAHS. Additionally, the maximal transverse diameter (1.87 ± 0.40 vs. 2.31 ± 0.44 cm, p = 0.015) and cross-sectional area (1.98 ± 0.46 vs. 2.74 ± 1.01 cm2, p = 0.032) of the airway were decreased in the soft palate plane in patients with OSAHS. The AHI was positively correlated with the thickness of the soft palate and lateral pharyngeal wall but negatively correlated with the maximal transverse diameter and cross-sectional area of the airway in the soft palate plane. CONCLUSIONS: Airway stenosis and pharyngeal tissue hypertrophy are typical characteristics of changes in the structure of the upper respiratory tract in patients with acromegaly who present with OSAHS. AHI is a predictor of the severity of the respiratory tract changes.
Authors: Thalijn L C Wolters; Sean H P P Roerink; Linda C A Drenthen; Jolanda H G M van Haren-Willems; Margaretha A E M Wagenmakers; Johannes W A Smit; Adrianus R M M Hermus; Romana T Netea-Maier Journal: J Clin Endocrinol Metab Date: 2020-01-01 Impact factor: 5.958