Egophony
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Egophony (
British English British English (BrE, en-GB, or BE) is, according to Lexico, Oxford Dictionaries, "English language, English as used in Great Britain, as distinct from that used elsewhere". More narrowly, it can refer specifically to the English language in ...
, aegophony) is an increased resonance of voice sounds heard when auscultating the lungs, often caused by
lung consolidation A pulmonary consolidation is a region of normally compressible lung tissue that has filled with liquid instead of air. The condition is marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is conside ...
and
fibrosis Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of perma ...
. It is due to enhanced transmission of high-frequency sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out. It results in a high-pitched nasal or bleating quality in the affected person's voice.


Technique

While listening to the lungs with a stethoscope, the patient is asked to pronounce the modern English (more generally, post-
Great Vowel Shift The Great Vowel Shift was a series of changes in the pronunciation of the English language that took place primarily between 1400 and 1700, beginning in southern England and today having influenced effectively all dialects of English. Through ...
) long-E vowel sound.


Interpretation

Stethoscopic auscultation of a clear lung field during this articulation will detect a sound matching that received through normal hearing; that is, the sound articulated by the patient will be clearly transmitted through the lung field and heard unchanged by the clinician. When the lung field is consolidated (filled with liquid or other solid mass such as tumor or fungus ball), the patient's spoken English long E will sound like a "pure-voweled" long E or a modern English long A without the latter's usual offglide. This effect occurs because the solid mass in the lung field will disproportionately dampen the articulated sound's acoustic overtones higher in the harmonic series, transmuting the English long E, in which higher overtones predominate strongly, to a sound (the English long A) in which higher overtones predominate only slightly, ''i.e.'', to a markedly lesser degree than in the former sound. This finding is referred to in clinical contexts as the "E to A transition." If associated with fever, shortness of breath, and cough, this E to A transition indicates pneumonia.


Related terms and techniques

Somewhat related,
bronchophony Bronchophony is the abnormal transmission of sounds from the lungs or bronchi. Bronchophony is a type of pectoriloquy. It is a general medical sign detected by auscultation. Technique The patient is requested to repeat a word several times whil ...
, a form of
pectoriloquy Pectoriloquy is the increased resonance of the voice through the lung structures, so that it is clearly comprehensible using a stethoscope on the chest. It usually indicates consolidation of the underlying lung parenchyma. Types include egophony ...
, is a conventional respiratory examination whereby the clinician auscultates the chest while asking the patient to repeat the word "ninety-nine". Better phrases in English include "toy boat”, "Scooby Doo", and “blue balloons". In the UK, regional variation with clinicians from Edinburgh to Glasgow use the phrase "one-one-one" due to its more rounded sound. Similar terms are
bronchophony Bronchophony is the abnormal transmission of sounds from the lungs or bronchi. Bronchophony is a type of pectoriloquy. It is a general medical sign detected by auscultation. Technique The patient is requested to repeat a word several times whil ...
and
whispered pectoriloquy Whispered pectoriloquy refers to an increased loudness of whispering noted during auscultation with a stethoscope on the lung fields on a patient's torso. Usually spoken sounds of a whispered volume by the patient would not be heard by the clinici ...
. The mechanism is the same; that is, fluid or consolidation causes the sound of the voice to be transmitted loudly to the periphery of the lungs where it is usually not heard.


Causes

*
Pleural effusion A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilog ...
, though egophony is only heard above the level of the effusion in an upright patient. *
Pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity ...
(lung consolidation) *
Fibrosis Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of perma ...


Etymology

Egophony comes from the Greek word for "
goat The goat or domestic goat (''Capra hircus'') is a domesticated species of goat-antelope typically kept as livestock. It was domesticated from the wild goat (''C. aegagrus'') of Southwest Asia and Eastern Europe. The goat is a member of the a ...
," ( αἴξ ''aix'', ''aig-'') in reference to the bleating quality of the sound.


See also

*
Vocal fremitus Fremitus is a vibration transmitted through the body. In common medical usage, it usually refers to assessment of the lungs by either the vibration intensity felt on the chest wall (''tactile fremitus'') and/or heard by a stethoscope on the chest ...


References


External links


Abnormal Respiratory Vocal Sounds
{{Circulatory and respiratory system symptoms and signs Audible medical signs Symptoms and signs: Respiratory system