Why Does the Nose Whistle in Some People?

Though most people like the professional nose whistler shown here require an instrument to enable the nose to whistle, in others it occurs naturally due to unique anatomic features within the nose.

Why might someone's nose whistle?

Septal Perforation

The most common reason it may occur constantly is due to a hole in the septum (septal perforation). The septum is a wall that divides the right nasal cavity from the left side. Normally, it should be straight and without any openings.

However, when a hole is present in the septum and it is in just the right size and place, whenever air is breathed in and out the nose, it will whistle. In this situation, the hole is the "window" of the whistle and the nose itself is the mouthpiece.

Correction of this problem is by either closing the hole (septal button or surgery) or making it bigger such that the aerodynamics eliminate the conditions conducive to nasal whistling. As an FYI, surgical correction of a septal perforation is quite difficult.

Septal Deviation and Some Nasal Congestion

The other situation when the nose may whistle, but only intermittently, is when there is a deviated septum. In this scenario, the septum rather than being straight, it is slightly crooked to one side making one side more narrow than the other.

Add some slight swelling of the nasal lining such that the opening of the nose is restricted to just right size and shape, and it may whistle.

This type of nasal whistling is akin to grass whistling (blowing between two thumbs holding a blade of grass).

Thankfully, the nasal conditions that lead to nasal whistling is quite rare and requires the perfect storm of just the right amount of septal deviation with just the right amount of nasal congestion.

As such, correction of this problem is fairly easy as one needs to change either the congestion causing the nasal lining to swell with a nasal spray or anti-histamine OR fix the deviated septum. If the inferior turbinates are enlarged, they can be reduced in size as well.

Of course, one can take this unusual condition and make it a positive feature worthy of a concert hall... WITHOUT the assistance of any instrument!

New Reason for Chronic Cough... Playing the Trombone!

NPR published a story on Sept 8, 2010 regarding a trombone player whose chronic cough for over 15 years was ultimately found to be due to a mold called fusarium as well as mycobacterium (cousin to TB) found growing inside his trombone. Each time he inhaled while playing the trombone, these germs inside his trombone was causing an allergic reaction, which led to hypersensitivity pneumonitis, a severe inflammation of the lungs.

The doctor who figured out the problem went on to investigate other wind/brass instruments of other players and found them all contaminated with germs. His results have been published in the journal Chest.

Though the NPR story was on this particular trombone player (whose cough improved once he started cleaning his instrument regularly), the problem is NOT new...

Here's a report on a saxophone player.

There is also this one company called MaestroMD that claims to help with musical instrument sterilization.

This issue was so concerning in Massachusetts, that a law is being passed to require sterilization of musical instruments in schools! Read more here.

I even wrote a blog article about this problem back in January 7, 2010.

In any case, how does the trombone player featured in the NPR story now clean his instrument? He uses a rod with a cloth and alcohol — rubbing alcohol or isopropyl alcohol which he pours down into his instrument after playing.

References:
Trombone Player's Lung: A Probable New Cause of Hypersensitivity Pneumonitis. Chest. 2010 Sep;138(3):754-6.

Hypersensitivity Pneumonitis Due to Molds in a Saxophone Player. CHEST September 2010 vol. 138 no. 3 724-726.

A microbiological survey into the presence of clnically significant bacteria in the mouthpieces and internal surfaces of woodwind and brass musical instruments.

Horn with nasty microbes.

Can Playing a Wind/Brass Instrument Be a Source of Recurrent Infections?

Is playing a wind/brass instrument a significant factor for recurrent strep, URI's, sinus infections, etc in people? Is such use contagious? If so, how does one even go about "sterilizing" the instrument after use by a sick person so that they don't infect themself again as well as players around them when blowing into it?

I got asked these questions by one astute parent of a trumpet player. After some inquiries and research, I actually don't have a good answer to whether they may be contagious and a source of germs, though it would make sense that they would be (well-known medical principle being bacteria grows in dark wet areas).

In any case, there are various techniques as well as common sense to try and semi-sterilize the instrument to prevent potential bacterial growth deep in the pipes of wind/brass instruments:

1) Don't share your instrument! Here's a journal article regarding the hazards of sharing instruments.
2) Thoroughly dry out the instrument after use via air and brush.
3) Never play the instrument while you are sick.
4) Replace the reed if it looks nasty. Clean mouthpiece thoroughly daily.
5) Brass instruments can indeed be washed in the bathtub with warm soapy water (not so for silver!)
6) Many players commonly angle their instruments up in the air when playing allowing some fluid to drain back. This practice can create a path for harmful bacteria to make its way back into the mouth from the body of the instrument. Try and avoid doing this!

There is also this one company that claims to help with musical instrument sterilization.

MaestroMD

This issue was so concerning in Massachusetts, that a law is being passed to require sterilization of musical instruments in schools! Read more here.

Here's a NPR news article on a trombone player whose instrument  caused a chronic cough due to mold contamination.

Do readers have any other suggestions? Please post a comment!

References:
- A microbiological survey into the presence of clnically significant bacteria in the mouthpieces and internal surfaces of woodwind and brass musical instruments. Link

- Horn with nasty microbes. Link