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embouchure dystoniaJoe Segen2016-12-29T10:13:40+00:00
PERFORMING ARTS MEDICINE
A sensory-motor dysfunction which affects brass and woodwind instrumentalists.
Embouchure The adjustment–a combination of puckering and smiling–which is required of the mouth to fit the mouthpiece of a wind instrument. It involves at least 12 muscles of the mouth, face, jaw, and
tongue (see bottom image for the anatomy).
• Air leaks at the corners of the mouth, which may be worse in higher
registers–due to increased pressure required, and accompanied by tremor.
• Abnormal contractions of facial muscles in the face; involuntary puckering and mouth closing; excessive elevation of the corners of the mouth; involuntary closing of the mouth.
• Difficulties may be limited to sustained notes in particular registers or to certain passages at specific speeds.
• Psychological stress
Aetiology Unknown; embouchure is highly task-specific; genetic factors may play a role.
Treatment Symptomatic; various drugs have been tried with varying degrees of failure, including Artane–trihexyphenidyl, Klonopin–clonazepam, and Lioresal–baclofen. Botox injections may be effective, with the proviso that regional anatomy must be carefully considered to avoid unacceptable weakness of embouchure-critical muscles.