Craniofacial abnormalities and their relevance for sleep apnoea syndrome aetiopathogenesis in acromegaly.
OBJECTIVE
To explain the effect of craniofacial relations on the development of the sleep apnoea syndrome (SAS) in acromegaly, and to elucidate how the activity of acromegaly affects the severity of SAS.


METHODS
Prospective observational study.


METHODS
Cephalometry and sleep ventilation measurements were performed in 26 acromegalic men and in 96 men with SAS.


RESULTS
SAS was found in 20 acromegalic men. Compared with non-acromegalic men with SAS, patients with acromegaly and SAS were found to have: enlargement of almost all linear dimensions; increased angle indicating mandibular protrusion; increased difference between maxillary and mandibular protrusion; articular angle decrease; soft palate lengthening; and pharyngeal airway space (PAS) enlargement in the palatal and uvular-tip planes. A comparison of acromegalic men with and without SAS revealed no significant difference in the craniofacial skeleton, although there was a narrowing of the minimal PAS (MinPAS) and of PAS in the uvular-tip plane in patients with SAS. SAS was more frequent in the patients with active acromegaly. MinPAS in the patients with active acromegaly was narrower than in those without disease activity.


CONCLUSIONS
Skeletal abnormalities in acromegalic men with SAS were different from those in SAS patients without acromegaly. Upper airway narrowing due to changes in pharyngeal soft tissues takes a more relevant share in the development of SAS in acromegalic men than skeletal anomalies.
Dostalova
S
S
Department of Neurology, 1st Medical Faculty, Charles University, Prague, Czech Republic. mak@internet.cz
Sonka
K
K
Smahel
Z
Z
Weiss
V
V
Marek
J
J
Horinek
D
D
D000172:Acromegaly / Q000150:complications* / Q000473:pathology; D000328:Adult; D000368:Aged; D002508:Cephalometry; D019465:Craniofacial Abnormalities / Q000150:complications* / Q000473:pathology; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000209:etiology* / Q000473:pathology
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I