LARYNGOSCOPY AND FIBEROPTIC INTUBATION IN ACROMEGALIC PATIENTS

Acromegaly is recognized as a cause of difficulty in airway management and intubation. We evaluated prospectively the conditions for laryngo scopy and fibreoptic intubation in 15 acromegalic patients. Each patie nt served as his or her own control. Ventilation of the lungs with a f ace mask was successful in all patients. In five of 15 patients the vo cal cords could not be seen using the Macintosh laryngoscope with a si ze 5 blade. Difficult laryngoscopy was associated significantly with t he number of attempts required to see the vocal cords with the fibresc ope (P<0.01, Spearman rank correlation). The larynx could not be seen with both techniques in one patient, and the trachea was intubated bli ndly with the help of an introducer. Our results showed that fibreopti c intubation may prove difficult or fail in acromegalic patients. Diff iculties in seeing the vocal cords with a fibrescope were present most often in patients who also had probable intubation difficulties with a rigid laryngoscope.