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. 2023 Oct 9;76(4):e20220674. doi: 10.1590/0034-7167-2022-0674

Chart 3. Characteristics of studies that assessed auditory-perceptual effects in the integrative review.

Title Country/year Design/number of patients Intervention Outcome Level of Evidence
Effects of face masks on acoustic analysis and speech perception: Implications for peri-pandemic protocols(3) Australia, 2020 Cross-sectional study
n=7
With intervention of mask use. Face masks alter the speech signal, but measures of vocal quality remain unchanged. IV
Impact of face masks in public spaces during COVID-19 pandemic on daily life communication of cochlear implant users(29) Netherlands, 2020 Prospective research study
n=221
No intervention. Face mask use reduces Cochlear Implant (CI) users’ quality of life. IV
Effect of Wearing a Face Mask on Vocal Self-Perception during a Pandemic(30) Brazil,
2021
Observational, descriptive and cross-sectional study
n=468
No intervention. Face mask use increases the perception of symptoms and vocal discomfort, especially in individuals who used them for professional and essential activities. IV
Effects of face masks on speech recognition in multi-talker babble noise(31) USA,
2021
Randomized clinical trials
n= 200
With intervention of mask use. Different types of masks show similar accuracy at low background noise levels and more apparent at high noise levels. II
Face mask type affects audiovisual speech intelligibility and subjective listening effort in young and older adults(32) USA,
2021
Non-randomized controlled trial
n=180
With intervention of mask use and environmental noise addition. Older adults showed worse general intelligibility and classified speech as more difficult to process compared to young adults III
Impact of Masks on Speech Recognition in Adult Patients with and without Hearing Loss(33) USA,
2021
Case-control
n=45
No intervention. Dramatic decrease in word recognition scores when the provider utters words through an N95 mask and especially when the speaker is a woman. (p < 0.001; 95% CI:10-26%). IV
Influence of surgical and N95 face masks on speech perception and listening effort in noise(34) Germany, 2021 Prospective, observational study
n=17
No intervention. Face masks reduce speech perception and increase listening effort in different noise signals. IV
Powered air-purifying respirators used during the SARS-CoV-2 pandemic significantly reduce speech perception(35) Germany, 2021 Cross-sectional study
n = 10
No intervention. The assessed powered air-purifying respirator system can be considered for high-risk procedures in SARS-CoV-2 positive cases in conjunction with a hearing protector. IV
The cafeteria study: Effects of facial masks, hearing protection, and real-world noise on speech recognition(36) USA,
2021
Cross-sectional study
n=34
With intervention of mask use and environmental noise addition. Speech recognition in real-world listening environments can be hindered by PPE worn by speakers and listeners. IV
The impact of face masks on the recall of spoken sentences(37) Germany, 2021 Non-randomized controlled trial
n=32
No intervention. Listeners remembered significantly fewer words when the phrases were spoken with a face mask. III
Influence of Protective Face Coverings on the Speech Recognition of Cochlear Implant Patients(38) USA,
2021
Prospective cohort study
n=23
No intervention. The type and combination of protective face coverings used have differential effects on the attenuation of speech information, influencing the speech recognition of patients with hearing loss. IV
Communication with face masks during the COVID-19 pandemic for adults with hearing loss(39) Canada,
2022
Cross-sectional study
n=656
No intervention. Increased public awareness and use of a transparent mask were determined to be examples of practical supports for effective social interaction. IV
How Face Masks Interfere With Speech Understanding of Normal-Hearing Individuals: Vision Makes the Difference(40) Germany, 2022 Prospective cohort study
n=15
Different experimental conditions with and without simulated face masks using the audio-visual version of the female German matrix test. Face mask use by the speaker leads to a deterioration in speech understanding by the listener. IV