喉頭結核を疑わしめた妊娠性嗄声の1例

　緒論

　日本鼻耳咽喉科学会第42回宿題報告中に松田教授は妊娠と喉頭との関係の部に於て，妊娠時喉頭に見られる他覚的所見は発赤と腫脹で自覚的症候は声音の異常，呼吸困難，出血なりというが，呼吸困難を來した例は豊田の報告によれば自家経驗例を併せて最近僅かに4例であるという．

　本症例の如く肺結核の患者で妊娠末期に呼吸困難を伴う妊娠性嗄声を起し正規分娩の経過を俟つて産後諸症状殆んど消散するに至つた例は甚だ珍らしいもので，臨床鑑別診断上興味深いものと考えられるので茲に報告する次第である．

Hara says diagnosis of aphonia of pregnancy in his case was difficult to make and highly confusing with that of laryngeal tuberculosis. Symptoms co-mpla ined of by the patient were marked dyspnea and aphonia. X-ray examinations of the chest revealed tuberculous lesions of the lungs and the sputum was positive for mycodacterium tu- berculosis. Laryngeal examination showed the mucous membrane to be edematous, ecchymosis of ventricles and paralysis of the muscles of closure. However, after the dilivery which in itself was normal, laryngeal symptoms were re-markable by disappearance. The diagnosis of aphonia of pregnancy was derived by elimina-tion. The author reflects that response to adre-nalin inhalation and vitamin therapy should have suggested a criterion for an appropriate differential diagnosis. Adroitness here is a grave question as it may involve the life of fetus.