Egophonia, bronchophony and whispered pectoriloquy – what to say?

Voice-generated sounds can provide essential clues about respiratory abnormalities. Normal lungs are stuffed with air, and air doesn’t carry sound easily. Typically, transmitted voice sounds are difficult to listen to – spoken words are muffled and indistinct, and whispered words are often not heard in any respect. However, when substances akin to liquid or solid masses replace the air within the lungs, sounds are transmitted more clearly. The sounds that could be assessed are:

• Ask the patient to whisper a sequence of words, akin to “one-two-three” and listen with a stethoscope. Usually only faint sounds are heard. However, in areas of tissue abnormality, the whispered sounds will likely be clear and distinct.
• Ask the patient to say “99” in a standard voice. Listen to the chest with a stethoscope. The expected conclusion is that the words will likely be blurry. Bronchophonia occurs if sounds are clearly heard.
• While listening to the chest with a stethoscope, ask the patient to say the vowel “e”. For normal lung tissues, you’ll hear the identical “e” (as in “beetroot”). If the lung tissue becomes consolidated, the “e” sound will change to a nasal “a” (as in “say”).

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s Guide to Physical Examination and History Taking (13^vol ed.). Wolters Kluwer Health: Philadelphia.