Is orthognathic surgery indicated for wind instrument players? A multiple case study

Introduction For the ambitious wind instrument player with severe malocclusion, the decision to undergo orthognathic surgery can be difficult. Aim To qualitatively explore and reveal key aspects of considerations for and outcomes of orthognathic surgery by interviewing a group of advanced and professional wind instrumentalists. Materials and methods One investigator, using a standardised questionnaire, interviewed seven cases. The interviews were analysed by two investigators who are knowledgeable about embouchure. Outcomes An ideal jaw relationship is not a prerequisite to achieving a professional career in music. Complete embouchure loss after surgery can be experienced due to changes in the position of incisors, lip relationship and tongue position relative to the shape of the oral cavity and as a result of neurosensory changes. Neurosensory recovery and 'wind instrument rehabilitation' takes at least six months, which was achieved in three out of five cases. The following temporary or permanent difficulties during playing after surgery were reported: onset of notes, high notes, leaps and intervals, and stable and well-tuned sound. Conclusion In view of the risks involved, orthognathic surgery in wind instrumentalists should only be considered when there is an (oral) health indication.