Acromegaly is a chronic, debilitating discase 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)
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