Summary
Objectives
We aimed to critically appraise scientific, peer-reviewed articles, published in the
past 10 years on the effects of hydration on voice quality in adults.
Study design
This is a systematic review.
Methods
Five databases were searched using the key words “vocal fold hydration”, “voice quality”,
“vocal fold dehydration”, and “hygienic voice therapy”. The Preferred Reporting Items
for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. The included
studies were scored based on American Speech-Language-Hearing Association's levels
of evidence and quality indicators, as well as the Cochrane Collaboration's risk of
bias tool.
Results
Systemic dehydration as a result of fasting and not ingesting fluids significantly
negatively affected the parameters of noise-to-harmonics ratio (NHR), shimmer, jitter,
frequency, and the s/z ratio. Water ingestion led to significant improvements in shimmer,
jitter, frequency, and maximum phonation time values. Caffeine intake does not appear
to negatively affect voice production. Laryngeal desiccation challenges by oral breathing
led to surface dehydration which negatively affected jitter, shimmer, NHR, phonation
threshold pressure, and perceived phonatory effort. Steam inhalation significantly
improved NHR, shimmer, and jitter. Only nebulization of isotonic solution decreased
phonation threshold pressure and showed some indication of a potential positive effect
of nebulization substances. Treatments in high humidity environments prove to be effective
and adaptations of low humidity environments should be encouraged.
Conclusions
Recent literature regarding vocal hydration is high quality evidence. Systemic hydration
is the easiest and most cost-effective solution to improve voice quality. Recent evidence
therefore supports the inclusion of hydration in a vocal hygiene program.
Key Words
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Article info
Publication history
Published online: November 06, 2017
Accepted:
October 2,
2017
Identification
Copyright
© 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.