Acromegaly And The Airway

Question 0

What other pathologies might you see with acromegaly

Answer 0

visceromegaly (Organs enlarged)

osteoarthritis

Skeletal muscle weakness

glucose intolerance

Peripheral neuropathy

Question 1

What is acromegaly

Answer 1

Gigantism

the excess secretion of growth hormone producing a general increase in size of the skeleton, soft tissues, and connective tissues.

Question 2

What structures are affected by acromegaly in regards to the airway

Answer 2

Nose, nasal passages

maxilla, mandible

mouth, tongue

pharynx

larynx: epiglottis, glottis, vocal cords, cricoarytenoid joint

trachea

Question 3

What are some airway signs and symptoms associated with acromegaly

Answer 3

Hoarseness
stridor
abnormal speech

all due to laryngeal changes

Question 4

True or false. The patient with acromegaly has extra-large nasal passages

Answer 4

False.

Nasal passages are smaller than normal due due to turbinate overgrowth. Limit nasal Instrumentatio.

Question 5

In regards to extubation what might you want to consider for these patients

Answer 5

They should be awake and alert for extubation given the fact that they are not good candidates for nasal airways

Question 6

Macroglossia is often seen with acromegaly, what problems might This present?

Answer 6

Upper airway obstruction

increased difficulty with DL

Question 7

True or false. You should upsize your ETT when planning to intubate the patient with acromegaly.

Answer 7

False.

The trachea is normal size you should NOT upsize your ETT

Question 8

What are some considerations when performing a transphenoidal hypophysectomy on a patient with Acromegaly

Answer 8

Careful airway management

anode orotracheal tube

secure OETT

fixed head frame - use NMB

moving page of the spinal drain placement