Objectives: Sleep apnoea has been consistently reported to occur in acromegaly. In uncontrolled patients, the severity of sleep apnoea influences physical activity in the daytime. We investigated the influence of disease activity on tongue volume and sleep apnoea treated with the GH receptor antagonist pegvisomant in poorly controlled patients with acromegaly under octreotide. Design and methods: A total of 12 patients with active acromegaly (six females; six males; mean age 57G15 years; body mass index 29.4G4.2 kg/m 2 ; meanGS.D.) were treated with pegvisomant (13.5G5.0 mg/die) for 6 months. Tongue volume was examined by magnetic resonance imaging, and sleep apnoea was characterized by polysomnography before and after 6 months of treatment with pegvisomant. The mandibular length was determined by lateral X-ray films. Results: IGF1 levels decreased after 6 months in all patients (407G114 to 199G23 mg/l; PZ0.0001). The tongue volume decreased (105G33 to 83G33 ml; PZ0.007) as well as the apnoea-hypnoea index (23G22 to 18G18/h; PZ0.0066). The mandibular length correlated with the initial tongue volume (r 2 Z0.6072, PZ0.0028). Conclusion: In conclusion, successful treatment with pegvisomant can decrease tongue volume, which has benefits for coexisting sleep disordered breathing.
In order to investigate the influence of radiation therapy after the treatment of maxillary implant-supported prostheses, 27 patients received a total of 131 implants in maxilla after oral cancer treatment and/or reconstructive surgery. Among them, 25 received maxillary implant-supported prostheses. The cumulative survival rates of implants and prostheses were evaluated by the product-limit-estimates method according to Kaplan-Meier. The cumulative survival rate of implants and prostheses in irradiated patients was compared with that in non-irradiated patients by statistical Log-rank test. The results showed that 112 implants were observed after implant loading. The implants cumulative survival rate was approximately 65% for overall patients. The cumulative prosthesis successful rate was approximately 88% for all 25 patients. Log-rank test analysis revealed that there was a significant difference in cumulative implants survival rates between non-irradiated and irradiated maxillary bone (P < 0.01). It was concluded that the implants and prostheses in irradiated patients have significantly lower survival rates than in non-irradiated patients.
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