The prevalence, causes and management of stress velopharyngeal insufficiency in woodwind and brass players

Abstract

The performance-related disorder, stress velopharyngeal insufficiency, can occur in some wind instrumentalists. Symptoms of nasal air leak during instrument playing can be intermittent and frustrating. Diagnosis and management of symptoms can often be prolonged which potentially threatens career opportunities for a professional musician. From the limited published literature about the disorder numerous methods of management have been used. There is still little information on the lived experience of a musician who has stress VPI. This thesis examines the prevalence, causes, assessment and management methods for stress velopharyngeal insufficiency (VPI) and also explores the musician’s lived experience of having the disorder. Results from this study demonstrate that stress VPI is a frequent occurrence amongst advanced wind instrumentalists. A working model of stress VPI has been developed which provides information on possible management pathways and recommends a number of health professionals who may assist with each method of management. Students and teachers should benefit from employing the suggested recommendations; thereby improving their knowledge about the disorder; identifying symptoms early; and making an informed decision about the most appropriate assessment and management options. These recommendations may also be used for future guidelines for health professionals who treat musicians with stress VPI.