A Literature Review of Velopharyngeal Insufficiency and Stress Velopharyngeal Insufficiency in Wind Players

A literature review was conducted to evaluate diagnostic tools, as well as surgical and non-surgical reparative options used to diagnose and rehabilitate musicians suffering from velopharyngeal insufficiency (VPI) in musicians. Purpose: The purpose of this paper is to inform music educators and physicians of the prevalence, underlying causes, and possible manifestation of VPI in their students. Methods: Databases (PubMed and Web of Science), a scholarly search engine (Google Scholar), and journal archives (Medical Problems of Performing Artists) were searched yielding a total of 395 possible studies. After the exclusion criteria were applied (must include a minimum of one wind instrumentalist), 32 studies were selected for analysis. Results: As a result, 23 case studies from 1970 and 2018 were found to include relevant information about symptoms, diagnostic tools, and treatment options pertaining to VPI and SVPI in musicians. Conclusions: Nasal grunting, hypernasality, facial grimacing, decreased vocal intensity, fatigue, and maladaptive articulation were some of the side-effects of VPI in musicians. VPI under stress, known as SVPI, has been characterized as a potentially career-preventing or career-ending phenomenon. Medical intervention is often recommended to diagnose and treat VPI in musicians. To improve the quality of medical care for these musicians, more instrument-specific research is needed in this area.