An Approach for Endotracheal Intubation in Acromegaly Patient / 대한마취과학회지

ABSTRACT

Acromegaly is a chronic,debilitating disease by excessive growth hormone production due to pituitary adenoma. Anesthesiologists are frequently confronted with problems such as excessive mandible protrusion, macroglossia and tracheal stenosis, which make intubation very difficult and risky in acromegalic patients.So, the authors tried to predict difficult intubation because acromegalic patients have anatomical change of airway.With X-ray film of acromegalic patient, measuring atlanto-occipital gap(2.5 mm), mandible ramus angle(8.4 cm), mandibulo-hyoid distance (35 mm), level of hyoid bone (between 4th and 5th cervical bone) provide clues to perceive difficult intubation. By abnormal data of these measurements, we can anticipate the difficult intubation with moderate accuracy compared with normal patient. It is prudent to consider using other methods such as fiberoptic bronchoscopic intubation, blind endotracheal intubation and transtracheal jet ventilation when difficult endotracheal intubation is predicted in those patients. (Korean J Anesthesiol 1995; 29: 310~314)