Characteristics of the upper respiratory tract in patients with acromegaly and correlations with obstructive sleep apnoea/hypopnea syndrome.

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.