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 cleft palate
Author: Misty 
Date:   2002-11-19 09:33

Hi, does anyone know how a cleft palate would affect my playing the clarinet? I was born with a cleft palate, but had surgery to correct it, however there seems to be a little air coming down my nose when I try to blow the clarinet. Is this something normal or is it something still wrong with me? Is there anything I can do about it? I thought about using a nose clip, like swimmers wear, but don't want to cause any injury to myself.

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 RE: cleft palate
Author: Dan Borlawsky 
Date:   2002-11-19 13:58

Misty -

It's possible there's no residual problem from the cleft palate; maybe your mouthpiece is a bit too open, or your reeds too hard. You possibly should experiment with those parameters.

Good luck in finding a solution!

--Dan

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 RE: cleft palate
Author: Terry Horlick 
Date:   2002-11-19 14:37

Misty,

As you know there are several types of cleft palate and cleft lip combinations possible. The repair for each is a bit different. So the answer to your question will require your dentist or physician to look inside your mouth and nose to help determine what is happening.

Some of the goals of palate surgery are to get you to where you can eat without passing material into your nasal cavity or pharynx and to speak as clearly as possible. Some surgery involves just routing some tissues to the back of the throat. This flap surgery creates a way for you to use your throat muscles to close off the nose in function. Other forms of surgery close a hole in the hard palate.

None of the surgeries are designed to allow you to raise the pressures you need in playing a clarinet, only that required for speaking and swallowing. The fact that you can play at all is either due to the nature of your initial cleft, the skill of your surgeons, or your adaptability in learning muscle function to work around a structural problem. Since you find air leaking into your nose it will be necessary to find where it is leaking. If you had the hard palate closed there is often a residual submucosal cleft. This area in the roof of your mouth is delicate and can be damaged allowing air to escape. Also it may have had a residual defect since the surgery which you have disclosed through pressure testing with your clarinet.

By obturating your nose you will be pressurizing your nasal cavity to the same pressure that your mouth reaches. This should theoretically allow you to play. It may take a small time to reach playing pressure, but you show so much determination that you probably will overcome this. Another concern is that you will also be pressurizing your middle ear through your "ear tubes". It will be more difficult for you to hear the groups you play in and to hear yourself. A cold will be much more of a challenge for you to work around while playing than it is for most folks.

The nose clip will be a bit uncomfortable as it will have to be tight enough to resist being dislodged when your nose is pressurized equal to the pressure in your mouth. I think the soft reed/close mouthpiece lay combination above would probably serve you well as you learn to play with less air pressure than most of us use.

I admire you for choosing a task which is challenging for you and working to find a solution! Your doctors may not be able to find a surgical defect, but if they do it may be possible to correct it either surgically or with a dental appliance. No one can really answer what is happening in your case without looking inside your mouth and nose.

Best wishes, Terry

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 RE: cleft palate
Author: Bob 
Date:   2002-11-20 17:33

Misty, no opinions or experience but since you posted and considering your perseverance I want to wish you good luck

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 RE: cleft palate
Author: Josh Schultze 
Date:   2002-11-22 13:44

I believe the body part that is being referred to here is the Filtrum.

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 RE: cleft palate
Author: Terry Horlick 
Date:   2002-11-23 01:40

<img src="http://pages.sbcglobal.net/thorlick/images/mcharette.jpg" align="right"> No I am sure that misty is not mistaking her philtrum for her palate. If she had a defect in her philtrum it would be termed a cleft lip. Also it is highly unlikely that a defective philtrum could leak air into the nasal cavity. A philtrum is the area from below the nose to the upper lip. Normally the philtrum is grooved.

Every anatomic area on the body has a name and is specific as to location and description. Confusion creeps in when we mix in lay terms. The palate is a kind of generic term as there is really a soft palate and a hard palate either or both may display clefts. In addition areas of the palate are distinct.

I hope that this photo serves to raise your commissures!
Terry

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 RE: cleft palate
Author: Misty 
Date:   2002-12-10 17:46

Sorry I haven't got back to you all in so long, but your information is useful. I will be visiting my doctor soon to see if I can have an operation to help repair my palate again. I am using a nose clip and it works well, so far. I love it!

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