Videofluoroscopic and laryngoscopic evaluation of the upper airway and larynx of professional bassoon players.

The bassoon is a demanding double-reed woodwind instrument requiring exquisite control of airflow and air pressure to the reed to produce desired tonal characteristics. Little information is available from direct visualization of the vocal tract and larynx of the bassoonist while playing. Of particular interest is the mechanism(s) of vibrato. This study was undertaken to understand more fully the mechanics of the upper airway in bassoonists during music production. Four adult bassoon players served as subjects. Three players were studied with both sound-synchronized videofluoroscopy and fiber-optic nasal endoscopy. The other subject was studied only by fiber-optic endoscopy. All subjects were evaluated while playing various scales and standard passages common in music pedagogy. The results from this study revealed several findings on the mechanics of upper airway activity during playing: (1) firm velopharyngeal closure was a prerequisite for maximal containment of air pressure and regulation of airflow in the oropharyngeal regions; (2) changes in the pitch and intensity were associated with differential expansion of the pharynx; (3) tongue activity was notable because of its shaping the size and shape of the airway, its role in regulating airflow to the reed, and its contributions to conditioning airflow in vibrato; and (4) slight vocal fold displacements from subglottal airflow and epiglottic movements from tongue base activity contributed to airway changes during vibrato. These seemed to further condition subglottal pressure trains derived primarily from expiration.