Moisturizing and Lubricating for High Vocal PerformanceAlfonso Borragán Torre, PhD
Centro de Foniatría y Logopedia
Current voice pathology research revealed that viscoelasticity of the vocal fold (VF) is one of the most important factors for optimal vocal function. Viscoelasticity is affected by the combination of polysaccharides and proteins present in the lamina propria1. However, a further element is required to create the ideal environment – water.
To hydrate a specific area of the body (eyes, upper airway, urogenital system) sufficient water is always needed. The amount varies depending on the individual and the environment. Too much fluid can increase laryngopharyngeal reflux in susceptible people and, consequently, affect the voice adversely. This leads us therefore to ask the question “Is Oral Hydration ideal?” In the last 10 years, increased research on hydration and lubrication of the Upper Airway resulted in what we call the “Gelling Effect”. The results have been amazing.
Moisturizing is providing water inside the tissue to impregnate it, so that it becomes more turgid, and spongier. This must always occur inside the tissue and not only on the surface2. The best ways to moisturize the larynx are by drinking water, or by breathing in water such as in a saturated environment with humidity at 100%. We can achieve as similar effect by breathing through soaked gauze for 10 minutes. It is important to keep the gauze wet, wetting it as often as necessary.
Water naturally tends to be in the form of droplets due to its being an electric dipole. Thus, water may not moisturize a large area spontaneously due to its tendency to compact. Making “water wetter“ and spreading it is vital when seeking to achieve a greater moisturizing effect. This effect may be achieved by the use of surfactants3 (e.g. sugar, pectin) or by maneuvers that break the surface tension of water (such as phonation, the application of heat through vapors or wet saunas, and other techniques).
It is also important to take into consideration the surface on which the water is deposited: an impervious surface will cause the water droplets to compact and thus not penetrate into deeper structures. When water is absorbed into the lamina propria, the mucosal wave increases, better glottal closure is achieved, and a feeling of comfort is generated, making speaking feel more effortless. In addition, with a well-hydrated VF, it may be possible to have increased vocal contact forces without incurring harm or injury.
The effect of nasal or inhaled oral hydration on the larynx is greater when we combine the breathing in of moisture with the production of gentle sound. This combination optimizes water penetration into the tissues. The moisturizing effect can last between 30 minutes and several hours.
Lubricating is making the mucosa surface moist. We lubricate the throat naturally by keeping saliva in the throat for several minutes without swallowing. Alternatively, we can achieve the same, if not better, effect by providing lubricating substances such as pectin gel with 25% Aloe Vera or with Vitamin E (although Vitamin E may have side effects including increased risk of bleeding). Good lubricant may help the mucosa remain moisturized longer.
A video demonstration on http://gellingeffect.com/lubrication/ shows the effect of pectin gel on a patient with glottal dysfunction stemming from a prior vocal paresis. The lubrication reportedly lasts several weeks, although evidence-based research is needed to confirm or refute this effect. In addition, it is reasonable to surmise that a good lubricant may help the self-healing process of the vocal folds.
My team always incorporates the Gelling Effect for any vocal therapy. The Gelling Effect is, without a doubt, the best “healing potion” for the voice. It is vital to activate the gelling code.
- Madruga de Melo E., Lemos M., Ximenes Filho J., Ubirajara Sennes L., Nascimento Saldiva P., Hiroshi Tsuji D.: Distribution of Collagen in the Lamina Propria of the Human Vocal Fold. Laryngoscope, 2003, 113: 2187-2191.
- Leydon C., Sivasankar M., Lodewyck Falciglia D., Atkins C., Fisher K.: Vocal Fold Surface Hydration: A Review. J. Voice, 2009: 23, 658-665.
- Melciades M., Costa B., Maliska C.: A New Hypothesis for FLuidification of Vocal-Fold Mucus: Scintigraphic Study. J. Voice, 2012: 26, 276-279.