EpistemisAmphoric vocal resonance
Specialty: Respiratory.
Why it occurs
- Massive unilateral stabilized pneumothorax without cardiovascular collapse (transmission of high frequencies of the patient's voice that resonates in the large pleural air chamber, acquiring a metallic and hollow character similar to the sound produced inside an amphora)
- Giant tuberculous cavern with peripheral location and very rigid walls
- Giant fluid-free intrapulmonary air cyst
- Giant thin-walled emphysematous bulla that occupies more than 30% of the hemithorax
- Giant post-infectious pneumatoceles (common after Staphylococcus aureus pneumonia in the chronic phase).
Initial workup
Digital chest x-ray in forced expiration and standing (facilitates the visualization of small pneumothoraces or delimits the outline of giant bullae); Computed tomography (CT) of the chest; Dynamic pleuropulmonary ultrasound; Complete respiratory function tests.
red flags
Association of amphoric resonance with visible or palpable contralateral tracheal deviation, jugular engorgement, progressive asphyxiating dyspnea, or drop in oxygen saturation below 90% (indicators of severe thoracic space compromise with mediastinal compression).
Standard management
- Symptomatic treatment and management of the causal pathology through pleural drainage or surgical resection of bullae if necessary
- Oxygen therapy with moderate flows to accelerate pleural air reabsorption if it is a small, uncomplicated pneumothorax of less than 15-20%.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Respiratory
- Listed causes
- 5
- Treatment options
- 2