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 Tonsillectomy Affecting playing?
Author: PoetiClarinet 
Date:   2011-01-24 00:46

I am 23, n have been playing the clarinet for 13 years, since age ten. had a tonsillectomy when I was 12 years old. It did not keep me from succeeding on my instrument, i made section leader in most ensembles I been in. However, Occassionally, while playing, I have a problem of air seeping through my nose or building pressure in my ears, and it affects how long I can play. I'm assuming the lack of tonsils changed the shape of my oral cavity and thus altered the pressure. It isn't an everyday thing, but some times after a long playing session, I can no longer get sound out the clarinet because there is so much air lost through my nose, or pressure built up in my throat. Any advice or has anyone had a similar problem? I'm really worried because my Senior recital is coming up in April, and I am fearing that the problem will rear its head again and I won't be able to complete my recital!

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 Re: Tonsillectomy Affecting playing?
Author: kdk 
Date:   2011-01-24 02:05

I had a tonsillectomy 43 years ago at age 20. The bad news is that I have had exactly the same problem you've described ever since. The good news is that the air leakage doesn't really seem to be a problem for me *when I'm in shape*. It does become a problem when I choose or need to take a break of more than a couple of days from playing. Then I need to gain my endurance back, just as most players would need to do for their embouchures.

I do not ever have a problem getting through a standard 2-1/2 hour orchestral rehearsal - there are enough rests and stops, and for me it's the fatigue of continuous playing that sets off the problem when it happens. I don't have a problem either with double rehearsals or a rehearsal in the afternoon and a concert at night. I don't do really long practice sessions - maybe 90 minutes at a stretch with an occasionally break for a glass of water. If I begin to have air leakage problems at that point and I have more to do, I put the clarinet down and come back to it later.

My surgery was at the beginning of my junior year in college (early September). I wasn't able to play at all - couldn't put enough air through the mouthpiece because of the glottal leak - until late in November. As I remember, recovery from that point on was pretty rapid. I think you'll be OK by the time you're in the final throes of preparing for your April recital. You may need to schedule your practice to avoid long, continuous sessions (which won't do your carpal and ulnar tendons any harm, either).

Good luck.

Karl

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 Re: Tonsillectomy Affecting playing?
Author: tictactux 2017
Date:   2011-01-24 06:58

My tonsils were removed when I was a young pup, say 8 or 9 years old. Fortunately, I have never encountered air seeping out the wrong places, except when my mouth was extremely tired.

I've reading a bit about the subject and found this: http://www.clarinet.org/clarinetFestArchive.asp?archive=30. (The air seems to leak not because of the missing tonsils but rather because of the operation injury.)
Anyhow, good luck with your recital.

--
Ben

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 Re: Tonsillectomy Affecting playing?
Author: Alex Eich 
Date:   2011-01-24 08:47

Hi there,

I too have had this problem and believe it is a result of having my tonsills removed, however, I had mine done at a very young age (I think it was when I was 4... already it's a little blury) and didn't start playing 'till age 7ish, so didn't have to deal with a change after starting playing.

I say "have had" because I no longer find it an issue. It was a problem for me when I suddenly jumped from doing around 40mins/day of practice to doing some rehearsals for a gig which were 2hrs. My embouchure be ok, but the back of my mouth, especially the roof/back, would just die on me and I wouldn't be able to keep the stream of air steady - kept leaking out through my nose as you said. At the time, I was nearing grade 7 level. As I worked my way towards my grade 8 exam, I thought I might encounter it again as I started practicing for more than 1:15/day, but I didn't. I'm sure this was because of the gentle work up to the increased time rather than throwing myself in the deep end as I did previously.

In short, I empathise, and I'm sure it won't be an issue if you build up to whatever duration of playing is required.

Good luck :)

Alex

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 Re: Tonsillectomy Affecting playing?
Author: David Spiegelthal 2017
Date:   2011-01-24 17:15

I had a tonsillectomy when I was a kid, and since I never got to be a good enough bass clarinetist to perform with a major symphony orchestra, I must blame it on the operation. Other than that, I've never experienced any effects from having that little bit of worthless whatever-it-is removed.

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 Re: Tonsillectomy Affecting playing?
Author: Gregory Williams 
Date:   2011-01-24 17:33
Attachment:  fl0019990.pdf (86k)

I believe there are a couple of studies out there.

Try velopharyngeal insufficiency


www.rcm.ac.uk/cache/fl0019990.pdf



Or Here is Another Article:


Volume 44, Issue 4
(July 2007)
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Print ISSN: 1545-1569
Frequency: Bimonthly
American Cleft Palate-Craniofacial Association
To find out more about ACPA please visit the website.
Table of Contents

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Article Citation:
Deonne Malick, Jerry Moon and John Canady (2007) Stress Velopharyngeal Incompetence: Prevalence, Treatment, and Management Practices. The Cleft Palate-Craniofacial Journal: July 2007, Vol. 44, No. 4, pp. 424-433.
doi: 10.1597/06-176.1

ORIGINAL ARTICLES
Stress Velopharyngeal Incompetence: Prevalence, Treatment, and Management Practices

Deonne Malick, Ph.D., Jerry Moon, Ph.D., and John Canady, M.D.
Abstract

Objective: Stress velopharyngeal incompetence is the unwanted coupling of the oral and nasal cavities while brass and woodwind musicians play their instruments. This study investigated both (1) the prevalence of stress velopharyngeal incompetence in college musicians, delineating symptoms and situations possibly associated with the condition; and (2) physicians' experiences with musicians exhibiting stress velopharyngeal incompetence, including typical treatment and management techniques.

Methods: Questionnaires were distributed to 297 brass or woodwind student musicians at three public universities and to 998 plastic surgeons and otolaryngologists. The musician questionnaire focused on demographic data and identification of symptoms that might indicate the presence of stress velopharyngeal incompetence. The physician questionnaire addressed demographics of the physician and his or her practice, familiarity and experience with stress velopharyngeal incompetence, and treatment and management suggestions for individuals experiencing the condition.

Results: Thirty-four percent of the responding musicians reported symptoms of stress velopharyngeal incompetence, most often after 30 minutes of playing. Forty-five percent of the responding physicians reported being familiar with the term stress velopharyngeal incompetence, although only 27% reported ever having seen a patient with the condition. The seven most frequently reported intervention strategies were referral to a speech language pathologist (47.50%), sphincter pharyngoplasty (30.00%), pharyngeal flap (26.88%), referral to a cleft palate team (24.38%), watch and wait (18.75%), posterior wall fat injection (12.50%), and palatal lift (10.00%).

Conclusions: Stress velopharyngeal incompetence is a potentially career-ending (or career-preventing) problem that currently may be undertreated and that is in need of more systematic study both in terms of its physiologic underpinnings and its management.

Keywords: musicians, stress velopharyngeal incompetence, velopharyngeal function

Received: September 2006; Accepted: January 2007

Dr. Malick is Manager, Speech Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. Dr. Moon is Associate Professor, Department of Speech Pathology and Audiology, University of Iowa, Iowa City, Iowa. Dr. Canady is Professor, Department of Otolaryngology–Head and Neck Surgery, University of Iowa, Iowa City, Iowa

Address correspondence to: Dr. Deonne N. Malick, Manager, Speech Pathology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Office #1117E, Tampa, Florida 33612. Deonne.Malick@moffitt.org

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