Direct Versus Video Laryngoscopy in Patients With Acromegaly

NCT07659912 | Not Yet Recruiting

• 1 other identifier: ACRO-VL-2026
• Study Type: observational
• Target: 40
• Locations: 0 countries
• Sites: N/A

Brief Summary

Acromegaly is associated with craniofacial skeletal changes and upper airway soft tissue hypertrophy, which may increase the risk of difficult laryngoscopy and tracheal intubation. This prospective observational study aims to evaluate airway and intubation characteristics in patients with acromegaly undergoing surgery under general anesthesia and to compare direct laryngoscopy and video laryngoscopy findings. Adult patients with acromegaly and patients with nonfunctioning pituitary adenomas scheduled for surgery under general anesthesia will be prospectively enrolled between July 1, 2026, and August 31, 2026. Preoperative airway assessment parameters, hormonal data including growth hormone and insulin-like growth factor-1 levels, Mallampati score, modified Cormack-Lehane grade, intubation-related variables, and peri-intubation complications will be recorded.

Conditions

Acromegaly; Nonfunctioning Pituitary Adenoma

Keywords

Acromegaly; Difficult Intubation; Direct Laryngoscopy; Video Laryngoscopy; Cormack-Lehane Classification; Airway Management; Growth Hormone; Insulin-Like Growth Factor 1; Pituitary Adenoma

Outcome Measures

Primary Outcomes (1)

• Modified Cormack-Lehane Grade With Direct and Video Laryngoscopy

  The modified Cormack-Lehane grade obtained during direct laryngoscopy and video laryngoscopy will be recorded and compared to evaluate glottic visualization and the degree of laryngoscopic difficulty.

  During tracheal intubation procedure

Secondary Outcomes (8)

• Mallampati Classification Score

  Preoperative airway assessment before induction of anesthesia

• Time to Successful Intubation

  During tracheal intubation procedure

• Number of Intubation Attempts

  During tracheal intubation procedure

• Need for Adjunct Airway Maneuvers or Devices

  From induction of anesthesia until confirmation of successful endotracheal tube placement by capnography during the airway management procedure

• Peri-Intubation Oxygen Desaturation

  From anesthesia induction to 5 minutes after intubation

Study Arms (2)

Acromegaly Group

Adult patients diagnosed with acromegaly who are scheduled for elective surgery under general anesthesia requiring endotracheal intubation.

Nonfunctioning Pituitary Adenoma Group

Adult patients diagnosed with nonfunctioning pituitary adenoma who are scheduled for elective surgery under general anesthesia requiring endotracheal intubation.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients with acromegaly or nonfunctioning pituitary adenoma who are evaluated by the institutional pituitary diseases council and scheduled for elective surgery under general anesthesia requiring endotracheal intubation at Basaksehir Cam and Sakura City Hospital.

You may qualify if:

• Age 18 years or older
• Diagnosis of acromegaly and scheduled for surgery after evaluation by the institutional pituitary diseases council
• Diagnosis of nonfunctioning pituitary adenoma and scheduled for surgery after evaluation by the institutional pituitary diseases council
• Requirement for general anesthesia with endotracheal intubation
• Ability and willingness to provide written informed consent

You may not qualify if:

• Age younger than 18 years
• Refusal to participate in the study
• Presence of extrapituitary malignancy
• Emergency surgery
• Previous tracheostomy or major laryngeal/tracheal surgery
• Severe limitation of mouth opening preventing standard laryngoscopic evaluation
• Cervical spine instability or severe restriction of neck extension
• Patients requiring awake fiberoptic intubation according to preoperative airway assessment
• Patients for whom participation is considered unsafe by the responsible anesthesiologist

Sponsors & Collaborators

• Muzaffer GENCER: lead
• Başakşehir Çam & Sakura City Hospital: collaborator

Related Publications (3)

• Friedel ME, Johnston DR, Singhal S, Al Khalili K, Farrell CJ, Evans JJ, Nyquist GG, Rosen MR. Airway management and perioperative concerns in acromegaly patients undergoing endoscopic transsphenoidal surgery for pituitary tumors. Otolaryngol Head Neck Surg. 2013 Dec;149(6):840-4. doi: 10.1177/0194599813507236. Epub 2013 Oct 3.

  PMID: 24091425 BACKGROUND

• Ali Z, Bithal PK, Prabhakar H, Rath GP, Dash HH. An assessment of the predictors of difficult intubation in patients with acromegaly. J Clin Neurosci. 2009 Aug;16(8):1043-5. doi: 10.1016/j.jocn.2008.11.002. Epub 2009 May 19.

  PMID: 19457671 BACKGROUND

• Zhang Y, Guo X, Pei L, Zhang Z, Tan G, Xing B. High levels of IGF-1 predict difficult intubation of patients with acromegaly. Endocrine. 2017 Aug;57(2):326-334. doi: 10.1007/s12020-017-1338-x. Epub 2017 Jun 15.

  PMID: 28620866 BACKGROUND

MeSH Terms

Conditions

Acromegaly; Pituitary Neoplasms

Condition Hierarchy (Ancestors)

Bone Diseases, Endocrine; Bone Diseases; Musculoskeletal Diseases; Hyperpituitarism; Pituitary Diseases; Hypothalamic Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Endocrine System Diseases; Endocrine Gland Neoplasms; Neoplasms by Site; Neoplasms; Hypothalamic Neoplasms; Supratentorial Neoplasms; Brain Neoplasms; Central Nervous System Neoplasms; Nervous System Neoplasms

Central Study Contacts

Muzaffer Gencer, associate professor

CONTACT

+90 212 909 60 00; dr.m.gencer07@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Anesthesiologist

Study Record Dates

• First Submitted: June 13, 2026
• First Posted: June 22, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: June 22, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share