Velopharyngeal Incompetence in Musicians: A State-of-the-Art Review

Lucía Mata-Pose; Miguel Mayo-Yáñez; Carlos M Chiesa-Estomba; Jérôme R Lechien; Luigi A Vaira; Antonino Maniaci; Alberto M Saibene; Christian Calvo-Henríquez; Irma Cabo-Varela

doi:10.3390/jpm13101477

Velopharyngeal Incompetence in Musicians: A State-of-the-Art Review

J Pers Med. 2023 Oct 9;13(10):1477. doi: 10.3390/jpm13101477.

Authors

Lucía Mata-Pose¹, Miguel Mayo-Yáñez^{2

3

4}, Carlos M Chiesa-Estomba^{4

5}, Jérôme R Lechien^{4

6

7

8

9}, Luigi A Vaira^{4

10}, Antonino Maniaci^{4

11}, Alberto M Saibene^{4

12}, Christian Calvo-Henríquez^{4

13}, Irma Cabo-Varela^{2

14}

Affiliations

¹ School of Medicine, Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
² Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain.
³ Otorhinolaryngology-Head and Neck Surgery Department, Hospital San Rafael (HSR) de A Coruña, 15006 A Coruña, Spain.
⁴ Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, 75000 Paris, France.
⁵ Otorhinolaryngology-Head and Neck Surgery Department, Hospital Universitario Donostia-Biodonostia Research Institute, 20014 Donostia, Spain.
⁶ Department of Otolaryngology, Polyclinique de Poitiers, Elsan Hospital, 86000 Poitiers, France.
⁷ Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 91190 Paris, France.
⁸ Department of Human Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium.
⁹ Department of Otolaryngology-Head & Neck Surgery, Centre Hospitalier Universitaire Saint-Pierre, 1000 Brussels, Belgium.
¹⁰ Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy.
¹¹ Faculty of Medicine and Surgery, University of Enna "Kore", 94100 Enna, Italy.
¹² Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20122 Milan, Italy.
¹³ Service of Otolaryngology, Hospital Complex of Santiago de Compostela, 15701 Santiago de Compostela, Spain.
¹⁴ Health Sciences Programme, International Center for Doctorate (EIDUDC), Universidade da Coruña (UDC), 15001 A Coruña, Spain.

Abstract

The velopalatine sphincter is a muscular valve that creates a hermetic seal between the nasopharynx and the oropharynx. It guarantees phonation, swallowing, and breathing (forces expirations). In wind musicians, sphincter closure must be precise during sound generation. Its failure will cause velopharyngeal incompetence (VPI) and the end of professional success. The objective of this article was to conduct a state-of-art review of VPI in wind musicians with a systematic approach based on the PRISMA Statement. The etiology, epidemiology, clinic, diagnosis, and treatment of VPI in wind musicians were evaluated. The research was carried out in different databases (PubMed/MEDLINE, the Cochrane Library, Scielo) and through the Mergullador metasearch engine. A total of 20 publications were selected. VPI is a pathology that affects around one-third of wind musicians according to studies. It causes pharyngeal noises and nasal air emissions during performance. The main etiology seems to be the fatigue of the velopalatine sphincter muscles. The most used diagnostic techniques consist of clinical history, physical examination, and nasofibroscopy. There is no consensus among authors about therapeutic management. Future investigations are necessary to confirm that fatigue of velopalatine sphincter muscles and other factors that increase it are the main causes of VPI in wind musicians.

Keywords: head neck; insufficiency velopharyngeal; musicians; velopharyngeal incompetence; wind musicians.

Publication types

Review

Grants and funding

The costs of the APC were covered by Fundación Profesor Nóvoa Santos (Hospital Teresa Herrera, 1ª Planta. C/Xubias de Arriba, No. 84, 15006, A Coruña).