The Effect of Hydration on Voice Quality in Adults: A Systematic Review

  • Maxine Alves
    Correspondence
    Address correspondence and reprint requests to Maxine Alves, Department of Speech-Language Pathology and Audiology, University of Pretoria, PO BOX 11663, Selcourt, Springs, Gauteng 1567, South Africa.
    Affiliations
    Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa

    Department of Speech, Language and Hearing Sciences, University Ghent, Ghent, Belgium
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  • Esedra Krüger
    Affiliations
    Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa

    Department of Speech, Language and Hearing Sciences, University Ghent, Ghent, Belgium
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  • Bhavani Pillay
    Affiliations
    Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa

    Department of Speech, Language and Hearing Sciences, University Ghent, Ghent, Belgium
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  • Kristiane van Lierde
    Affiliations
    Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa

    Department of Speech, Language and Hearing Sciences, University Ghent, Ghent, Belgium
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  • Jeannie van der Linde
    Affiliations
    Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa

    Department of Speech, Language and Hearing Sciences, University Ghent, Ghent, Belgium
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Published:November 06, 2017DOI:https://doi.org/10.1016/j.jvoice.2017.10.001

      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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