SLPOtherJournal of voice : official journal of the Voice Foundation2017

Efficacy of Six Tasks to Clear Laryngeal Mucus Aggregation.

Heather Shaw Bonilha, Terri Treman Gerlach, Lori Ellen Sutton and 4 others

PMID 27469450

WHAT IT FOUND

Hard throat clearing significantly reduced thick mucus lumps and severe thickness, while the four common alternative behaviors did not clear mucus.

However, the study was too small to change clinical practice, and the alternatives remain biomechanically less harmful.

Key findings

01Hard throat clearing was the only behavior that significantly reduced type 3 mucus (lumps) and severe mucus thickness.

02Silent coughing, soft throat clearing, dry swallowing, and swallowing water did not significantly change mucus presence or thickness.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample size was small (46 participants), and the authors explicitly state it is premature to change clinical practice based on these results. Participants performed unfamiliar tasks without training, which may affect ecological validity. Water bolus size for swallowing was self-selected and not standardized. The study measured physical mucus removal, not patient comfort or vocal fold health.

The easy way to misread this

Do not advise patients to return to hard throat clearing because it is more effective at removing mucus. The study confirms it clears mucus but does not negate the known biomechanical harm of hard clearing; the alternatives are still preferred for tissue health despite being less effective at clearing.

Read it on PubMed →