Craniofacial abnormalities and their relevance for sleep apnoea syndrome aetiopathogenesis in acromegaly

Objective: To explain the effect of craniofacial relations on the developme nt of the sleep apnoea syndrome (SAS) in acromegaly, and to elucidate how t he activity of acromegaly affects the severity of SAS. Design: 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: enlarge ment of almost all linear dimensions; increased angle indicating mandibular protrusion; increased difference between maxillary and mandibular protrusi on; articular angle decrease; soft palate lengthening; and pharyngeal airwa y space (PAS) enlargement in the palatal and uvular-tip planes. A compariso n of acromegalic men with and without SAS revealed no significant differenc e in the craniofacial skeleton, although there was a narrowing of the minim al PAS (MinPAS) and of PAS in the uvular-tip plane in patients with SAS. SA S was more frequent in the patients with active acromegaly. MinPAS in the p atients with active acromegaly was narrower than in those without disease a ctivity Conclusion: Skeletal abnormalities in acromegalic men with SAS were differe nt from those in SAS patients without acromegaly. Upper airway narrowing du e to changes in pharyngeal soft tissues takes a more relevant share in the development of SAS in acromegalic men than skeletal anomalies.