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Air Leak Through the Nose?



 
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Joe N.
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PostPosted: Fri Jul 10, 2009 11:42 am    Post subject: Air Leak Through the Nose? Reply with quote

Yesterday as I was playing I experienced an uncomfortable air leak through the sinus passages of the nose. It caused a little soreness so I'm taking the day off today. This happened as part of a stretch of about 5 hours of playing in a row (with some breaks--practice then a gig). This has happened to me once or twice in the past, and I think it's being caused by fatigue turning into excess tension on top of the normal pressure build up from playing. Any insight as to how to deal with this if it ever comes back?
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lmaraya
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PostPosted: Fri Jul 10, 2009 12:35 pm    Post subject: Reply with quote

From Hickman's Trumpet Pedagogy:

INCOMPETENT PALATE
Excessive and involuntary air leakage through the nose during trumpet playing may be caused by a defective velopharyneal valve, or "incompetent palate," in the back of the oral cavity An incompetent palate is not uncommon. Many people are unable to whistle or blow up a balloor because they are unable to produce high intraoral air pressure.
The velophrarynageal valve is located in the back of the mouth where the soft palate begins, This valve opens and closes at will, allowing air to be passed through either the mouth or nasal passages. In rare cases, persons requiring continued high intraoral pressures can develop velopharyngeal incompetence over time. This phenomenon has been noted in glass blowers and more recently in wind musicians. Such pressures can sometimes cause syncopal attacks [fainting], headache, disturbances of vision, reflux parotitis, and pharyngeal wall herniations. It seems reasonable that an occasional palate, even if normally junctional, just quits junctioning under certain abuse. It also seems reasonable that the musicians blame their lips (so-called "dead chops") and that in some cases rest alone will improve the situation. (Dibbell, David, MD., Stan Ewanowski, PhD., and William Carter, MD. "Successful Correction of Velopharyngeal Stress Incompetence in Musicians Playing Wind Instruments." Plastic and Reconstructive Surge!)'. Vol. 64, No.5, Nov. 1979, pp 662- 664.)
Dr. David G. Dibbell, MD., introduced the trumpet community to the problems resulting from a defective velopharyngeal valve during the 1977 International Trumpet Guild Conference held at the University of Illinois in Urbana-Champaign. Dr. Dibbell presented a lecture describing case studies he conducted at the University of Wisconsin-Madison where he surgically corrected these defective valves in oboists and trumpeters. After the surgery, these musicians, who were previously unable to play in the high register because of the excessive involuntary air leakage through their noses could, for the first time, play in the upper registers of their respective instruments.
In Dibbell's article for the American Society of Plastic and Reconstructive Surgeons, he states: The ability to generate extremely high intra-oral pressures is a necessity for professional musicians who play wind instruments. This pressure can reach as high as 130 mm Hg (millimeters of mercury) whereas normal speech pressure rarely exceeds 5 to 6 mm Hg.
The musician who plays a wind instrument must direct this highly pressurized flow of air through his mouth; any leakage of air through the nose impairs his ability to play "high and long." To achieve the desired effect, a strong soft palate must seal off the nasal passages from the oral one upon command. Inability of the palate to "perform" makes the musician unable to perform. (Ibid.)
Dibbell lists average mouth pressures of instrumentalists playing fortissimo on different instruments:
Woodwinds: (mmHg)
bassoon 89.7
alto saxophone 56.2
B-flat clarinet 86.4

English hom 54.7
oboe 80.8
alto flute 31.7
flute 77.8
alto recorder 11.6
piccolo 58.3
Brass:
bass tuba 77.6
tenor tuba 64.7
trombone 126.0
French hom 115.9
A trumpet 107.8
C trumpet 125.8
D trumpet 132.4
In extreme cases of nasal air leaking, the velopharyngeal valve may require surgery to prevent it from leaking under high pressure. Testing is conducted with the use of fiber-optic pressure tubes placed in the mouth and nasal areas while the player plays his or her instrument. A computer monitors sensitive pressure changes to determine if the valve is leaking air involuntarily. Surgery involves placing the patient under anesthesia, removing a thin sliver of skin from the roof of the mouth and grafting it to the edge of the velopharyngeal valve so that it forms a complete air seal. The procedure takes approximately two hours and usually does not require hospitalization. Recovery is similar to having tonsils removed - patients can only eat soft foods for a couple of days and must allow two to three weeks of healing time before playing the instrument. (See: Dibbell, David G., "The Incompetent Palate: A Trumpeting Disaster." ITG Journal. Oct. 1977, p 37.)
Two of the author's university students underwent velopharyngeal surgery-a trumpeter and a trombonist. In each case, a full and beautiful tone was produced in the low and middle ranges. However, attempts to play in the middle-high or high registers resulted in the top notes failing miserably and noticeable "grunting" or "snorting" noises emanating from the player's nose. After the operations, each player acquired a normal upper register within a couple of days after they started playing again. Both musicians have had successful performing careers during the twenty-five years since the operations took place.
Velopharynageal surgery should not be considered unless symptoms persist for months. In most cases, minor nasal air leakage can be eliminated by consistent daily practice of two hours or longer.
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trumpetboy1455
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PostPosted: Sat Jul 11, 2009 10:31 am    Post subject: Reply with quote

I had this for about a month once I got my tonsils taken out because my soft palette was so weak. It went away after a month of solid careful practicing to get it back. It tended to happen when I started playing higher and louder. So I did pppp clarke studies and such. Really helps
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John Mohan
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PostPosted: Sat Jul 11, 2009 11:20 am    Post subject: Reply with quote

I have had this happen a few times in my life. Each time was under the same condition: I had stopped playing for a period of time (more than 2 weeks) and then jumped in and tried to play well above High C. Each time it happened to me, it only happened on the first day or two back playing. Problem quickly cleared up as I redeveloped my normal playing strength.

Be paitient and don't over-practice!

Best wishes,

John Mohan
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razeontherock
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PostPosted: Sat Jul 11, 2009 12:16 pm    Post subject: Reply with quote

lmaraya wrote:

Dibbell lists average mouth pressures of instrumentalists playing fortissimo on different instruments: (in mmHg)

A trumpet 107.8
C trumpet 125.8
D trumpet 132.4


I wonder if our resident physics experts can translate this into psi?

The multiple tongueing drill I just finished on the big Bb horn, going to F above high C, I would assert created and sustained higher pressures than the "average" D trumpet player - for the entire duration of my playing breath. And even just slurring, sustaining, and single tongueing A above high C, I would venture to guess creates higher pressure yet.

Yet recently I heard (yet again) from a very good source of trumpet info
that the max measured psi inside the mouth while playing trumpet is about 1 psi. WIDE discrepancy! The only way I can reconcile this is to think whatever device was inserted never entered the airstream. Mine is certainly sealed off from teeth and gums by my tongue as I play up there, and if a probe tried to work it's way through that seal I don't think I'd be able to play.
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Joe N.
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PostPosted: Sat Jul 11, 2009 1:03 pm    Post subject: Reply with quote

Mr. Mohan,

Sounds like what happened. I've been practicing, but not enough to be ready for a 5 hour gig. Not to mention I was probably playing louder than I thought I was due to the gig being outdoors. Today it seems better but not totally gone. I'll do some smart practice the next couple days and hope the issue goes away.


Last edited by Joe N. on Sun Jul 12, 2009 8:12 pm; edited 1 time in total
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crzytptman
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PostPosted: Sat Jul 11, 2009 1:18 pm    Post subject: Reply with quote

Try practicing and/or playing with ear plugs in.
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TrumpetMD
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PostPosted: Sat Jul 11, 2009 2:27 pm    Post subject: Reply with quote

In your case, if it's a conditioning issue, it should be transient. So I think your plan is a good one. As a doctor, I can add that velopharyngeal dysfunction can resolve with rest and a proper practice routine, unless there is an anatomic or neuromuscular etiology.

If it persists, and affects your playing, you have two choices. The more conservative option is to work on specific exercises to strengthen the soft palate. A speech pathologist may be able to help with this. Your other option (as was already stated) is to visit an ENT or plastic surgeon who is experienced with velopharyngeal insufficiency in musicians.
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trpt.hick
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PostPosted: Sat Jul 11, 2009 6:38 pm    Post subject: Reply with quote

Practicing lots of "K" tonguing is helpful in strengthening the pallete. In your case, it seems like you simply overplayed and need to recover. I wouldn't worry about it.

DH
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Jim-Wilson
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PostPosted: Sun Jul 12, 2009 5:32 am    Post subject: Reply with quote

razeontherock wrote:

Quote:
I wonder if our resident physics experts can translate this into psi?


These days you can get a lot of easy stuff figured for you. WolframAlpha is a new website with a lot of cool tools/calculating functions. Taking the last value for D Trumpet (132.4mmHg) and plugging it in gives the following result:

http://www90.wolframalpha.com/input/?i=132.4+mmHg+to+psi

For those of you not going to the link, the value is 2.546psi (or a bunch of other values as well if you want).
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Coltssop01
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PostPosted: Mon Aug 10, 2009 12:32 pm    Post subject: Reply with quote

trpt.hick wrote:
Practicing lots of "K" tonguing is helpful in strengthening the pallete. In your case, it seems like you simply overplayed and need to recover. I wouldn't worry about it.

DH


Hmmm...K tonguing to help this? Interesting. I have had this issue on and off for the past 10 years (mostly on unfortunately). I've learned various strategies to deal with it and try to prevent it from happening, including being very careful about breathing properly and not overplaying, but I've never heard of K tonguing helping it.

I think I shall go practice my K tonguing now.
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tptmajor
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PostPosted: Mon Aug 10, 2009 7:39 pm    Post subject: Reply with quote

I too agree with the idea to not overdo your practice sessions. Patience is the best thing. Many players have the tendency to practice more to help overcome problems such as this. In many instances this causes more harm than good.
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