The Effects of the Use of Protective Face Mask on the Voice and Its Relation to Self-Perceived Voice Changes



      The purpose of this study was to investigate the effects that the use of protective face mask has over the voice and to search for associations between the self-reported voice changes and the levels of discomfort experienced by the participants. Also, to detect any change it the phonatory patterns while speaking with face mask.


      This was a cross-sectional, observational study, conducted by distributing an online questionnaire. From a total of 155 people who participated in the study, 143 of them wore protective face mask during their working hours and qualified. Five groups of questions were used to measure the Speech Difficulties, the Mask Related Behaviors caused by the use of face mask, alterations in the Voice Perceptual Features, the Vocal Tract Discomfort levels and the Greek version of the Voice Handicap Index. The participants self-evaluated their voice and stated the frequency and severity of the symptoms they experienced during the mask usage period.


      The results showed that the use of protective face mask increases the self-perception of changes in the voice, especially in the voice-breathing coordination and has great effect on the intelligibility and overall communication. The majority of people stated that they have to speak louder and that they have noticed alterations in the perceptual features of their voice, with hoarseness, and volume being the most frequently affected. Almost every symptom on the Vocal Tract Discomfort Group was present with Dry, Lump in Throat, Tight, and Short Breath being the most severe, and Dry and Short breath being the most common among them. Physical, Functional, and Emotional affectations were also observed through the Voice Handicap Index.


      The use of protective face mask increases the vocal effort of the speaker, affects the voice-breathing coordination, limits the overall communication, alters the perceptual features of the voice, increases vocal track discomfort levels and results in psychosocial and socioemotional difficulties. All these affectations may result to the establishment of a voice disorder, especially in high-risk population.

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