Evaluation of velopharyngeal closing pressure during trumpet play with high-resolution manometry

Abstract

In about one-third of brass instrumentalists, there are stress-related insufficiencies of velopharyngeal closure (VPC), i. e. the intraoral pressure exceeds the barrier formed by the VPC. Here, it was the aim to measure the VPC closing pressure while playing a trumpet and to evaluate the influence of a 30 minute stress sequence on the muscular activities in the VPC. Sample: 6 healthy volunteers; task: to play the sound h1 for 5 seconds with 85 dB(A) and with 100 dB(A). High-resolution manometry (HRM). t0: measurement without warm up phase t1 after 30 min trumpet play; practice phase with predefined pieces of music. mean (pmit), minimum (pmin) and maximum pressure (pmax) in the VPA at t0 and t1. testing for normal distribution, t-test. All measured pressures in the VPC decreased from t0 to t1 for tones produced at 85 dB(A). For 100 dB(A) tones only the pmin decreased significantly. The pressures in the VPA were higher at 100 dB(A) tones overall compared to 85 dB(A) tones, significant differences were found for pmin and pmax at t0. Tones played at louder volumes require a stronger muscular contraction in the VPC. The lower VPC pressure after the exercise phase (t1) can either result from a physiological muscular adaptation to the pressure level necessary for a sufficient VPC or already be a sign of muscular fatigue. These findings may be important to assess the work ability of wind instrumentalists by HRM. As shown for the phonation, the VPC pressure profile for the trumpet play can also be described with a three-phase model consisting of an initiation, a stable phase and a termination.