 The Clarinet BBoard
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Author: Melissa Anderson
Date: 2013-03-19 21:25
Hi everyone.
I'm doing my degree dissertation on a condition called "Stress Velopharyngeal Incompetence", it is a condition which is not very common but it mostly happens with clarinettists. The condition is basically a palatal air leak whereas, whilst a musican is performing, a leak begins which allows air only to pass through the nose and nothing to come through the mouth, therefore no sound can be produced.
If you could take a few minutes to complete my online questionnaire I would be very grateful and if anyone has experienced this or knows more about the condition, please reply.
http://www.surveymonkey.com/s/9QNYC66
Thank you very much.
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Author: kdk
Date: 2013-03-19 22:24
A few comments suggested by some of the questions in your survey:
I have had difficulty with this since I had my tonsils and adenoids removed at the age of 20 (I will be 66 in May). I've consulted one otolaryngeologist (sp?) about it but he didn't have much of an idea of how to pursue it.
It always begins as I tire - an hour of straight, non-stop practice is often enough, although it depends a little on how resistant my reed is.
It happens when I'm practicing more than when I perform or rehearse with an ensemble, I think because performing and rehearsing are never as continuous as practicing at home (rests, not playing while the conductor rehearses strings or brass, intermissions, etc.). So I don't think it's related to performance anxiety (although, truthfully, I am a nervous player). I haven't played in a concert band in a long time, but I think band concerts were harder to get through - fewer long rests for the clarinets.
The leakage, at least when it starts, is not enough to cripple my playing. Enough air still gets to my reed to produce a controlled tone. If I keep going, though, it gets worse and eventually I have to stop. A half hour's rest and I can play again for awhile.
If you have any more specific questions, I'd be more than happy to discuss this further, perhaps by private email.
Thanks for looking at this - I'm sure I'm not the only clarinet player who deals with it.
Karl
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Author: Melissa Anderson
Date: 2013-03-19 22:33
Thank you for your reply.
It is interesting that this started when you had your tonsils removed as the condition can be caused by damage when they are removed, do you know if any damage was caused? I had my tonsils out when I was 5 and I suffer with the condtion, however, according to specialists, no damage was caused. I have heard the procedure is more dangerous when you're older so maybe something happened with yours?
Although, someone else I'm looking at is affected by this condition but she still has her tonsils.
It is proving quite difficult to come up with a reasonable explanation for why this leak happens.
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Author: gsurosey
Date: 2013-03-19 22:53
This happens to me! And, my tonsils and everything related to them are still very much intact. It has happened to me at different times (warming up too much for NYSSMA competitions when I was younger, as well as random occurrences during my lessons and rehearsals). I'm on the way to a rehearsal, but I'll fill out the survey when I get home.
----------
Rachel
Clarinet Stash:
Bb/A: Buffet R13
Eb: Bundy
Bass: Royal Global Max
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Author: kdk
Date: 2013-03-19 23:12
I don't know for certain whether damage was done. I didn't even try to pursue it for a couple of decades afterward. And it has always seemed as if dealing with it might be less trouble than risking more treatment, almost certainly surgical, and its possible unwanted consequences' perhaps making matters even worse.
It's the same basic reason why I don't get hip surgery.
It may be hard to come up with a consistent explanation because potentially a lot of things may cause it.
Karl
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Author: ruben
Date: 2013-03-20 08:26
Dear Melissa,
As a teacher, I had a student that had this problem and I had some success by getting her to inhale through her nose rather than through her mouth. Inhaling through the mouth allows you to take in more air and more quickly, so this wasn't ideal, but it did put something right; what exactly, I don't know.
rubengreenbergparisfrance@gmail.com
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Author: blazian
Date: 2013-03-20 19:50
I also have this problem, though rarely. I think it's a fatigue issue. It only happens to me after playing soft music for long periods of time. The first notable time it happened was when I was playing a clarinet solo accompanied by glockenchor (bell choir) where the part was fairly high and soft. The amount of control that I was using was wearing at my endurance in that area. After about 30 minutes of almost constant playing, I started getting short spurts of air leaking through and muscle tremors from whatever muscle I was using to direct air through my mouth.
I'm 20 and have not had any mouth/throat/nose work done. Wisdom teeth don't count.
- Martin
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Author: Melissa Anderson
Date: 2013-03-20 23:00
Thank you so much for your replies and for filling in my questionnaire, I am very grateful, I've definitely got lots of results to analyse.
I am still interested in hearing from other people to get as many results as possible.
This is a really interesting topic, unfortunately little is known about this condition but I am hoping to find out as much as possible.
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Author: The_Clarinetist
Date: 2013-03-22 15:37
Very interesting phenomena indeed. I believe my teacher confirmed some years ago that I might have a leakage through the nose. The problem must have grown away because I haven't noticed it in years now.
It might have been a matter of learning to control M. levator veli palatini via CN XI and the pharyngeal plexus so as to close nasopharynx with the soft palate.
Playing with high intraoral pressure should help to keep this valve closed passively. However, weak musculature and improper tension will lead to central or peripheral fatigue and consequently difficulty closing the valve.
Infections can cause swollen lymph nodes, theoretically resulting in an irregular surface and sealing problems. Improper sealing might further be attributed to dry mucosa. Once you have a leakage the air flow will make the mucosa even drier.
I should be able to pronounce "R" the way Swedes ordinarily do it but for me it sounds more like a German or French "R". It probably has to do with the pharyngeal musculature, innervation and the position of the uvula.
Good luck with your dissertation!
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Author: Mom
Date: 2013-03-23 03:56
I found this from an older thread, maybe you've seen it? I though it was interesting:
Author: sdr (---.meei.harvard.edu - (Qwest Communications) Boston, MA United States)
Date: 2011-07-14 16:58
Blummie has outed me again. I am an ENT doc -- though my practice for many years has been limited to disorders of hearing and balance.
Cleft palate and sub-mucous cleft palate are anatomic conditions that can be associated with velopharyngeal insufficiency -- incomplete closure of the soft palate against the back wall of the throat (pharynx), resulting in nasal air escape. Velopharyngeal insufficiency (VPI) is not an "all or none" phenomenon. Someone may be perfectly able to speak clearly, e.g. articulating "k" and hard "g" without air escaping through the nose, but have some degree of nasal air escape against the pressure of playing a wind instrument, especially with a more resistant set-up or with extended playing time. There are some people who can overcome this with practice and training (by a speech pathologist) and others who cannot. Physical exam by an ENT doc, and possibly by a speech pathologist, should determine if there is an insurmountable anatomic barrier to VP function. There may also by players who develop "functional" VPI -- the have completely normal VP anatomy and neuromuscular function but develop a pathologic habit of misusing the palatal muscles so they suffer nasal air escape -- sort of the palatal equivalent of lisping. I believe there was some discussion on this BB recently of a teenager who had been playing well but as he advanced he developed more nasal escape. That would be a typical story of functional VPI that might respond well to therapy with a speech pathologist.
-sdr
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Steven D. Rauch, MD
Professor, Otology & Laryngology
Harvard Medical School
Massachusetts Eye & Ear Infirmary
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Author: Melissa Anderson
Date: 2013-03-24 18:50
Thanks again for all the replies.
Do you know of any more coping mechanisms for this condition? That have helped ease your own problems or someone elses.
Post Edited (2013-03-24 18:50)
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Author: tiffyrad
Date: 2013-06-22 18:10
Hi Melissa,
Thanks for posting this. I am an oboist, and I have wondered about this problem on and off for years. After practicing a little this afternoon and experiencing this leakage, I was prompted to do a quick search and your post came up. After reading some of these replies - and another thread on a trumpet page, and taking your survey - here's what I noticed:
This problem does not occur very often for me, but I do remember some unfortunate instances in college - a recital, for example - when it occurred. It only happens when I am playing a long solo work - never in an ensemble setting.
Today, I was practicing on a harder reed than I should have been. I am playing solo for a wedding next week and a) wanted to save my best reeds and b) thought if I practiced on a harder reed it might help my stamina - like lifting heavy weights....(whether this is a good idea or not remains to be seen).
So, after playing on the harder reed and repeating sections multiple times - I experienced the leakage. There is an audible sound, and there is nothing I can do to stop this once it's begun. I did take a few breaths in through my nose once or twice before this occurred, so that I could keep my embouchure in position - maybe this contributed to the problem.
However, after taking a short break - enough time to read some posts and take your survey, I returned to practicing and chose a more comfortable reed. I was able to play through everything I had played only 10 minutes earlier, this time with no leakage at all.
I hope this helps you as much as reading the posts helped me. If this does occur again, and will immediately question my reed.
Thanks so much. Good luck with your dissertation.
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Author: Ken Shaw ★2017
Date: 2013-06-22 18:38
Surgical excision of loose portions of the soft palate, including the uvula, is often done to cure sleep apnea. This can cause velopharyngeal incompetence. My cousin, who had the procedure, says he has trouble blowing up a balloon. That's why I decided against the surgery and use a CPAP.
I've met several players over the years with VI and as far as I know, nobody has found a cure.
Ken Shaw
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Author: genekeyes ★2017
Date: 2013-06-23 02:25
Hi Melissa
If you contact me via email and provide an address, I have quite a bit of information that you might find helpful. I prefer not to discuss this online
Gene
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Author: JMR
Date: 2013-06-26 01:51
This is interesting because I have never heard anyone discuss the problem but I suffered from it myself long ago.
I had lots of illness due to tonsils as a child. My parents wanted to have them removed during holidays, summer breaks, etc. but I successfully talked them out of it through grade school & college. Just after I graduated from college I gave in & had the surgery. When I tried to play clarinet the first several times afterwards, I couldn't even get a sound...nothing but leaking air. It was most frustrating. I don't recall how long it took for the healing process, but I believe it was several weeks before I could really play again. The good news is that after I fully healed, the problem went away. I do recall that I switched to softer reeds for awhile & which made it easier to begin playing again & build up some endurance.
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