Voice sounds: bronchophony, egophony and whispered pectoriloquy !

Sign

The examiner listens while the patient speaks or whispers: if the voice comes through clearly, the lung beneath is solid.

Updated 2026-11-01

See it in 3D: Pleura · Lobar bronchi

What it is

Auscultating the voice tests the same thing as fremitus, but by ear. Over normal lung the voice sounds muffled and indistinct; over consolidation it sounds loud and clear (bronchophony), nasal (egophony) or even a whisper is clear (whispered pectoriloquy). These signs help confirm a suspected consolidation.

The anatomy it tests

Aerated lung filters out the high frequencies of the voice, the ones that make words intelligible.
Consolidated tissue with an open bronchus carries those frequencies well, so voice and whisper come through sharply.
At the upper border of an effusion, compressed lung and a thin layer of fluid change the voice quality (egophony).

How to elicit it

Patient seated; listen with the diaphragm at symmetric points, starting over the suspicious area and its mirror point.
Bronchophony: ask the patient to say 'ninety-nine' in a normal voice; compare loudness and clarity on both sides.
Egophony: ask the patient to say a long 'E'; note whether it sounds like a nasal, bleating 'A'.
Whispered pectoriloquy: ask the patient to whisper 'one, two, three'; normally the whisper is barely heard.
Mark the borders of the abnormal area and relate them to percussion and fremitus.

What a positive result means

All three positive over the same area, with dullness and increased fremitus: consolidation (pneumonia).
Egophony only in a band at the top of a basal dullness: pleural effusion compressing the lung.
Absent voice sounds with dullness: large effusion or atelectasis with a blocked bronchus.
A negative test does not rule out pneumonia, especially if small, central or early.

Usefulness and limits

These signs are fairly specific but not sensitive: their absence does not exclude consolidation.
They need a patient who can speak or whisper clearly; they cannot be tested in very ill or intubated patients.
A chest radiograph or lung ultrasound confirms consolidation.

Test yourself

Think of the answer, then tap the question to see it.

What is whispered pectoriloquy?

Hearing whispered words clearly when listening over the chest; it indicates lung consolidation.

Besides over consolidation, where can egophony be heard?

At the upper border of a pleural effusion, where the lung is compressed.

How are voice sounds in a pneumothorax?

Reduced or absent, because pleural air separates the lung from the wall and damps the voice.

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See it in 3D

The structures of Durgical's 3D anatomy where it is found.

← All of the clinical exam

Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.

Sources: Breath sounds: MedlinePlus Medical Encyclopedia (MedlinePlus, U.S. National Library of Medicine, 2024); Community-acquired pneumonia in adults: MedlinePlus Medical Encyclopedia (MedlinePlus, U.S. National Library of Medicine, 2024).

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Representative model, for educational purposes only.