Acromegaly presented as a cause of laryngeal dyspnea

Acromegalic patients can develop obstructive sleep apnea syndrome or upper airflow obstruction. The development of dyspnea is unusual and the fixation of both vocal cords is exceptional. We report the case of a patient with bilateral vocal cord paralysis. Fiberoptic laryngoscopy and computed tomogra...

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Bibliographic Details
Published in:Auris, nasus, larynx nasus, larynx, 2007-12, Vol.34 (4), p.541-543
Main Authors: Saussez, S., Mahillon, V., Chantrain, G., Thill, M.P., Lequeux, T.
Format: Article
Language:English
Subjects:
Acromegaly
Acromegaly - complications
Acromegaly - diagnosis
Acromegaly - surgery
Airway Obstruction - diagnosis
Airway Obstruction - etiology
Airway Obstruction - surgery
Diagnosis, Differential
Dyspnea
Dyspnea - etiology
Growth Hormone-Secreting Pituitary Adenoma - complications
Growth Hormone-Secreting Pituitary Adenoma - diagnosis
Growth Hormone-Secreting Pituitary Adenoma - surgery
Humans
Hypophysectomy
Laryngeal Diseases - diagnosis
Laryngeal Diseases - etiology
Laryngeal Diseases - surgery
Laryngoscopy
Male
Middle Aged
Pituitary Neoplasms - complications
Pituitary Neoplasms - diagnosis
Pituitary Neoplasms - surgery
Tomography, X-Ray Computed
Vocal cord paralysis
Vocal Cord Paralysis - diagnosis
Vocal Cord Paralysis - etiology
Vocal Cord Paralysis - surgery
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Summary:Acromegalic patients can develop obstructive sleep apnea syndrome or upper airflow obstruction. The development of dyspnea is unusual and the fixation of both vocal cords is exceptional. We report the case of a patient with bilateral vocal cord paralysis. Fiberoptic laryngoscopy and computed tomography (CT) of the neck showed a supra-glottic stenosis due to a swelling of the soft tissue. A tracheostomy was first performed. Thereafter, micro-laryngoscopy using laser vaporisation of the supra-glottic soft tissue was attempted but failed to remove the tracheostomy canula. Finally, blood tests and cerebral MRI revealed an acromegaly. The patient underwent a trans-sphenoidal resection of the pituitary adenoma. Fifteen months later, fiberoptic laryngoscopy showed bilateral restoration of vocal cord mobility and the tracheostomy canula was successfully removed after 18 months. Vocal cord fixation is probably due to hypopharyngeal and laryngeal soft tissue swelling and can be reversible after successful treatment of the adenoma.
ISSN:0385-8146
1879-1476
DOI:10.1016/j.anl.2006.11.014