Does the wearing of masks change voice and speech parameters?

Abstract

Purpose The authors aim to review available reports on the potential effects of masks on voice and speech parameters. Methods A literature search was conducted using MEDLINE and Google Scholar databases through July 2021. Several targeted populations, mask scenarios and methodologies were approached. The assessed voice parameters were divided into self-reported, acoustic and aerodynamic. Results It was observed that the wearing of a face mask has been shown to induce several changes in voice parameters: (1) self-reported—significantly increased vocal effort and fatigue, increased vocal tract discomfort and increased values of voice handicap index (VHI) were observed; (2) acoustics—increased voice intensity, altered formants frequency (F2 and F3) with no changes in fundamental frequency, increased harmonics-to-noise ratio (HNR) and increased mean spectral values in high-frequency levels (1000–8000 Hz), especially with KN95 mask; (3) aerodynamics—maximum phonatory time was assessed in only two reports, and showed no alterations. Conclusion Despite the different populations, mask-type scenarios and methodologies described by each study, the results of this review outline the significant changes in voice characteristics with the use of face masks. Wearing a mask shows to increase the perception of vocal effort and an alteration of the vocal tract length and speech articulatory movements, leading to spectral sound changes, impaired communication and perception. Studies analyzing the effect of masks on voice aerodynamics are lacking. Further research is required to study the long-term effects of face masks on the potential development of voice pathology.

COVID-19 masks: A barrier to facial and vocal information

“…Perception of speech was affected by mask in particular for the perception of bilabial syllables regardless of modality, suggesting that wearing a mask impairs the production of syllables involving the lips, consistent with reports that face mask alters speech articulatory movements (Gama et al, 2021). However, we did not find a general impact of masks on intelligibility, contrary to Cohn et al (2021) who reported altered perception for casual and positive speech, possibly due to controlling for intensity across masked and unmasked condition (Gama et al, 2021).…”

A rapid, non-invasive method for fatigue detection based on voice information

“…Voice recognition has also been applied for the prediction and evaluation of health conditions, such as mental health and emotional condition ( Pisanski et al, 2016 ; Holmqvist-Jämsén et al, 2017 ; Dibeklioglu et al, 2018 ; Pisanski and Sorokowski, 2021 ; Kappen et al, 2022 ). Recently, it has been applied to respiratory diseases such as COVID-19 to detect the health conditions of the patients and monitor the emotional states of the staff ( Castillo-Allendes et al, 2021 ; König et al, 2021 ; Gama et al, 2022 ). However, no vocal biomarkers have been approved by the US Food and Drug Administration or the European Medicines Agency so far.…”

Effects of Wearing FFP2 Masks on SARS-CoV-2 Infection Rates in Classrooms

“…To the best of our knowledge, the long-term effects of continued mask wearing have been investigated in only a few studies to date [ 35 , 36 , 37 , 38 ]. These suggest that the continued wearing of face masks may also have negative consequences, and these must be carefully balanced against the advantage of reduced infection rates.…”