Acromegaly. Use of fiberoptic laryngoscopy to avoid tracheostomy

Abstract

Anesthetic management of the acromegalic patient is associated with difficulties in airway maintenance and endotracheal intubation. Elective tracheostomy has been suggested when glottic abnormalities are present such as glottic stenosis or vocal cord paresis, especially when hypertrophy of pharyngeal mucosa is also present. Venus suggested without clinical evidence, that complications of a difficult endotracheal intubation and tracheostomy could be avoided by the use of a fiberoptic bronchoscope. This report illustrates the value of fiberoptic laryngoscopy in anesthetic management of an acromegalic patient who had severe hypertrophy of pharyngeal and laryngeal tissues.