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March 1992

The Hoarse Obstetrician—An Occupational Hazard

Author Affiliations

New Haven, Conn

Arch Otolaryngol Head Neck Surg. 1992;118(3):343-344. doi:10.1001/archotol.1992.01880030135029

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To the Editor.—In 1985 an obstetrician, a woman in her early 30s, presented with chronic hoarseness of 4 years' duration. She had never been a smoker. She took alcohol only rarely. She had suffered no trauma. She denied abusing her voice. Her general health was good. Physical examination of the ears, nose, and throat was normal. Fiberoptic examination of the larynx revealed only some slight fullness in the right true vocal cord. There was no tumor, polyp, or paresis. The impression was chronic laryngitis of uncertain cause and the patient was referred for voice instruction.

Over the following 4 years her voice became increasingly hoarse. She continued to deny exposure to irritants and voice abuse. By May 1989 the right anterior cord looked slightly red and irregular, but there was still no tumor. Her voice was almost a whisper.

In August 1990 she returned for reevaluation. She had taken

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