Acromegaly and sleep apnea: Cephalometric evaluations

Lateral teleradiography is a standard and quick examination. It has enabled us to define differences as regards to the craniofacial morphology between 20 acromegalic patients and 20 control subjects. The height of the mandibular ramus (from the posterior condyle point to the gonion point) increases significantly with the acromegalic patient and the cranial base angle (basion-superior tuberculum sellae-M point) is more extended. As acromegalic patients are more subject to sleep apnea (30% prevailing), the relationship between the amount of sleep apnea and hypopnea (AHI) in an acromegalic patient and his bone, tissue and hormone factors has been researched, in order to act on the causes of sleep apnea. It has emerged that confronting craniofacial bones and soft tissues factors enables a good prediction of the apnea and hypopnea index. Of course, we can find again the potential action of growth hormone (GH) but only in fifth place in importance order. The tongue, which increases in volume with the GH impact, is in a too short "lingual enclosure" (reduced length of the mandibular horizontal branch). (C) 2011 Elsevier Masson SAS. All rights reserved.