The sad pandemic situation that we are living, has provoked our indefinite and forced alliance to a protection tool called mask. Consequently, a multitude of them have been progressively made and made available to us, homemade masks, homologated and others not so safe. The nexus of the voice and the use of the mask is being a current issue because our vocal health concerns us, especially those people who use their voice as a working tool, and therefore, their salary depends on it.
Also, this concern resides in people who use their voice as a hobby or in those who are undergoing some kind of vocal training or rehabilitation. The voice requires a varied set of structures and organs to flow effectively, therefore, the best option is to have a vision of it as a whole. And more knowing the constant connection with our emotional state. Next we will talk about some essential characteristics to maintain a good vocal quality and why these are distorted or damaged by the use of masks.
Vocal articulation
If our objective is to carry out good phonoarticulatory movements, essential for good intelligibility, resonance and vocal projection, we must know that fabric masks will impair these movements during the phonatory act due to their high containment between the nose and the chin. Regarding the use of approved masks, surgical masks allow a greater vertical opening than hygienic or EPI masks (FFP2, etc.), although the latter accept greater lip mobility thanks to their design.
Therefore, as long as our environment (work, social or family) allows it, these masks will be the most indicated in articulatory terms. As vocal care guidelines, we should slow down our speech and enhance our gestural language.
Vocal hydration
Surgical masks and PPE, in addition to providing much more protection than fabric masks, will provide better breathability, a fundamental variable for correct vocal hydration, especially surgical masks. There are two types of vocal hydration: direct vocal hydration and indirect vocal hydration, and it is the latter that we cover with the gradual intake of at least 2L of water throughout the day, especially during vocal activity. This type of hydration does not moisten the vocal folds as if it were a bath, what really happens, in general terms, is a beneficial blood irrigation for the mucosa that surround our vocal folds.
Nowadays, with the amount of time we spend with the mask and the precaution of not removing it, we are drinking much less water, causing an incorrect vocal hygiene, and successive vocal problems. To avoid these difficulties, the best solution is a good hand hygiene prior to the momentary removal of the mask. Our recommendation is to insist, in addition to water intake, on direct vocal hydration. A fantastic option can be the use of a saline nebulizer (for about 10 minutes), pre and post vocal activity. Vaping with water and salt, and gargling with glycerin and bicarbonate are more economical options.
As a conclusion, and taking into account that our nasal cavities are a primordial filter in our phono respiratory system, system on which our vocal emission depends, we have to take care of its correct cleaning. Applying physiological saline solution directly through the nostrils with a certain pressure, cleaning both ducts, is a simple and effective way to do it. Another alternative is salt water, which we will press by using a syringe. The use of the humidifier is necessary especially in dry environments, places of rest or where vocal activity is developed and this characteristic is maintained.
Volume or intensity of the voice
The shouting or excessive increase of vocal intensity in compensation, the development of our activity in more or less noisy environments, with more or less sound reverberation, the concept of self-perception or auditory monitoring during the use of the mask linked to the ignorance of the number of decibels that each type of mask reduces us, are primary and influential ingredients in this variable commonly called voice volume.
The truth is that the masks hide our perception of the voice, causing the higher frequencies of our emission to be disguised and the lower frequencies to come out more successfully to the outside. This is key in terms of loudness and intelligibility, key elements for effective communication. Recent studies determine a loss of between 3 and 15 decibels, with the surgical mask being the most advantageous, while PPE and masks are recognized as barriers. It is true that the decrease in decibels and the consequent increase in voice intensity lack a sufficiently solid relationship to demonstrate this intention. Therefore, the problem lies more in our auditory self-perception or in the general or specific mismatch in vocal technique.
As advice, as long as the protection is not affected and our environment allows it, surgical masks will be the most convenient, with special mention to teaching. In the case of being obliged to wear FFP2 type approved masks, it will be advisable to take breaks, varied dynamics, or alternate with surgical masks at the end of each intense vocal activity. Those whose exercise allows it and require a good vocal projection as educators, should use wireless microphones as well as a good sound equipment. Currently, there are a multitude of inexpensive and totally effective examples.
As for telepractice and communication through video calls, the use of headphones will give us a better quality auditory feedback, in addition, most of them have a microphone placed near our oral cavity, which will provide efficiency to the communication.
The good use of the voice
Vocal prevention undoubtedly plays an advantageous role in voice disorders. Any vocal discomfort manifested as pain, itching, throat clearing, dryness, inflammation or variation in vocal quality should be studied by an otolaryngologist and then, if the latter deems it appropriate, remedied or rehabilitated by the speech therapist specialized in this field.
For our vocal health, it is crucial that none of these symptoms be ignored, as long as it is not a catarrhal or similar process.
This article is inspired by a publication by Damián Osorio, speech therapist specializing in voice rehabilitation.