title: Playing a brass instrument after total laryngectomy: a case report.
abstract: BACKGROUND
  A brass instrument is a musical instrument in which the tone is produced by vibration of the lips as the player blows into a tubular resonator. The case of a professional brass player who continued his activity after total laryngectomy, with insertion of a voice prosthesis in a tracheoesophageal shunt, is reported.
  
  
  METHODS
  A videoendoscopic and videofluoroscopic study of the patient during brass playing was conducted.
  
  
  RESULTS
  A nonvibrating, open neoglottis during brass playing was found on videoendoscopy. Videofluorography revealed an enlarged hypopharynx, a thick neoglottis while playing at lower tone; at higher pitch the tongue base was retracted, the neoglottis was thin and stretched, and the subneoglottic area was extremely enlarged.
  
  
  CONCLUSIONS
  The case reported shows that the insertion of a voice prosthesis in a tracheoesophageal shunt seems to create a regulating airflow system sufficiently advanced to play a brass instrument, further reducing the disability of laryngeal speakers.
authors.affiliation: Department of Otorhinolaryngology, University of Turin, Turin, Italy.
authors.forename: Andrea Luigi
authors.initials: AL
authors.lastname: Cavalot
authors.forename: Antonio
authors.initials: A
authors.lastname: Schindler
authors.forename: Elsa
authors.initials: E
authors.lastname: Juliani
authors.forename: Oskar
authors.initials: O
authors.lastname: Schindler
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cortesina
mesh_terms: D000328:Adult; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods; D007831:Larynx, Artificial; D008046:Lip / Q000502:physiology*; D008297:Male; D009146:Music; D009790:Occupations; D011312:Pressure; D013647:Task Performance and Analysis; D014741:Video Recording; D014833:Voice Quality