Incontinent Pallete

Discussion in 'Trumpet Discussion' started by BigBear, May 27, 2011.

  1. BigBear

    BigBear New Friend

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    Fellow Teachers,
    I need some ideas and help on a situation. There is a fellow who has been diagnosed (by a real M.D... not friends, lol) with an incontenent pallete. Basically, when he plays, he is leaking air through the flap in the rear of the throat that leads to the nose. So when he plays, one can physically feel air leaking from his nose. There is a surgery available to fix the problem, but that should only be as a "last resort". We have found that working a lot on tounging has helped somewhat... however, it is still unsatisfactory.
    Have you ever come across this isssue? How have you rememdied it? I've done some research but the only available options I seem to find it "live with it" or "get surgery". I do not like either of those options for him.
    This seems to be a recent development as well. The gentelman is over 40 and has been playing for several decades.

    Thakn you,
    BigBear
     
  2. TrumpetMD

    TrumpetMD Fortissimo User

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    I have come across this issue, both as a patient and as a physician. The more common term is "velopharyngeal insufficiency", which I mention for those wishing to "google" it.

    Does the person have an identifiable cause, such as a cleft palate, removal of his tonsils/adenoids, some other type of procedure in/near his throat, or neurologic disease? If so, it might be reasonable to address the underlying cause, if possible.

    Also, if this is a new condition in a 40-year-old after playing for many years, it would be important to fully work up why it may be happening. It could be something innocent related to his playing. Then again, it could be something medical.

    FWIW, many trumpet players have this problem, to one degree or another. It is often initermittent, appearing when a person plays beyond their normal endurance/tolerance. When there is no identifiable anatomic or neurologic etiology, and it is evident only when playing the trumpet, a better description is stress velopharyngeal insufficiency (given the velopharyngeal closure works under normal conditions, but not under stress).

    As a patient, I was affected by this after having my tonsils and adenoids removed back in the 5th grade. At first, any attempt to play resulted is all of the air leaking through my nose. I went through a series of breathing and tonguing exercises for about 6 months to be able to play again. It still have intermittent stress velopharyngeal insufficiency to this day (when I push beyond my normal tolerances), and have learned to live with it and work around it.

    Most of the medical therapies (speech pathology, oral appliances, and surgery) are directed towards those with true velopharyngeal insufficiency, not stress velopharyngeal insufficiency. But there is some overlap. In general, the breathing and tonguing exercises are what I would consider first.

    Feel free to PM me, if you want to talk about specifics.

    Mike
     
  3. kingtrumpet

    kingtrumpet Utimate User

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    wow - one more thing to worry about with my stage fright -- stress velopharyngeal causing my air to leak out!!! I'm going to google this now -- hope I don't become a hypochondriac -- thanks for the term so googling will be easier.
     
  4. kehaulani

    kehaulani Fortissimo User

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    Hey Mike, would this condition also apply to those who have had the uvula and other material in the back of the throat removed? I ask, because I'm one such person and I learned (with no special exercises or anything of the like) how to play wind instruments with this condition.

    Of course, I have no controlled research to know what percentage of folks might or might not be handicapped by this, but as for me, itit hasn't been a problem . . . once I learned to drink a glass of water without drowning myself.

    Oh, kingtrumpet - it's not the "stress velopharyngeal" or stage fright you have to worry about as time passes. It's the incontinent part. :D
     
  5. tedh1951

    tedh1951 Utimate User

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    Would a simple appliance like a nose clip used by, say syncronised swimmers, be a short term solution while the exercises are worked through? Just thinking out loud. Might this work as a fix for those who don't respond to the exercises? :dontknow:
     
  6. TrumpetMD

    TrumpetMD Fortissimo User

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    It's possible. Any procedures that alter the soft palate or oropharyngeal area can cause this.

    +1

    Interesting idea, but I'm not sure it would work. I remember trying this back in the 5th grade after my surgery. It didn't work well, and was uncomfortable from the pressure it built up in my ears (likely holding your nose and blowing to pop your ears).
     
  7. rowuk

    rowuk Moderator Staff Member

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    Even without this case I tried playing with my nose plugged. I can't recommend it.

    I think the key is to learn to play in a relaxed way and then make the decision if the body will cooperate or not. I am sure that there are enough that can and a couple that can't. Fact is that practically no trumpet player plays at their maximum efficiency. I discover tension everywhere. That can be worked on. The chances are probably pretty good for the player that has the natural talent of "patience"!
     
  8. tedh1951

    tedh1951 Utimate User

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    Nice of you blokes not to jump down my throat on this one - I had a small moment of disquiet about the suggestion, but then I always tell my students that there is no such thing a stupid question - if one person has that idea, then so might another who is unprepared to ask.
     
  9. Peter McNeill

    Peter McNeill Utimate User

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    I suffered from a bad sinus problem a long time ago, and this caused air leakage; I feel for anyone that suffers it long term.
     
  10. Peter McNeill

    Peter McNeill Utimate User

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    BTW Anti-histamines did the trick for drying up the sinuses.
     

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