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

New Images of Ear Hematoma After Treatment with Quilting Suture

New images have been added to our Cauliflower Ear webpage showing what the ear looks like after hematoma drainage and quilting suture applied after 1 week and after 6 weeks. The images are shown below.

Front Ear: 1 week after hematoma drainage and quilting suture applied.

Back Ear: 1 week after hematoma drainage and quilting suture applied.

Front Ear: 6 weeks after hematoma drainage and quilting suture applied.

Back Ear: 6 weeks after hematoma drainage and quilting suture applied.

WP: Vaccine that Prevents the High of Cocaine!

The Washington Post on January 5, 2010 published a story "Testing of cocaine vaccine shows it does not fully blunt cravings for the drug" describing research in which participants were unable to experience the high of cocaine with use. Apparently, the vaccine creates antibodies to the cocaine that prevented its effects.

Cocaine is an important illicit drug in the ENT world as it is associated with multiple nasal problems including septal perforation, nasal bleeding, rhinitis, nasal crusting, sinusitis, etc.

Read more about the story here.

RANDOM: Benford's Law Applied to Health?

Today, I listened to an amazing NPR RadioLab episode titled "Numbers."

In one of the stories in this episode, Jad and Robert Krulwich educated me on an interesting mathematical phenomenon called Benford's Law. Simply stated, Benford's Law states that in lists of numbers from many (but not all) real-life sources of data, the leading digit is distributed in a specific, non-uniform way. According to this law, the first digit of a number is "1" almost one third of the time, and larger digits occur as the leading digit with lower and lower frequencies, to the point where 9 as a first digit occurs less than one time in twenty. This is completely contrary to the expectation that the number 9 or 8 should occur equally as frequently as 1 or 2.


(From "The First-Digit Phenomenon" by T. P. Hill, American Scientist, July-August 1998)

But get this... This law holds true whether talking about random samples from a day's stock quotations, a tournament's tennis scores, the numbers on the front page of The New York Times, the populations of towns, electricity bills in the Solomon Islands, the molecular weights of compounds, the half-lives of radioactive atoms, and much more.

It seems to me that if the universal natural state of order follows Benford's Law... I wonder whether it also holds true for the human body...

I did a pubmed search and it seems that there have been a few researchers who had the same idea, most applied only to basic biological processes:

- Biologic kinetic rate parameters follow Benford's Law (abstract)
- mRNA transcription data from a wide range of organisms and measured with a range of experimental platforms show close agreement with Benford's law (abstract)
- Different states of anesthesia can be detected by Benford's Law (link)

Just for giggles and kicks, I looked up normal bloodwork values for a human being. This website nicely listed the most common normal values. I than jotted down the frequencies of the first integer of all the lab values listed and here's what I came up with:

#1 (30.5%)
#2 (17.1%)
#3 (10.2%)
#4 (10.2%)
#5 (7.3%)
#6 (7.3%)
#7 (6.5%)
#8 (5.8%)
#9 (5.1%)

Amazingly... though the frequencies don't match up perfectly, they do come eerily close to Benford's Law.

With larger lists of numbers, the approximations may come even closer. Potential neat project for a student, eh?

New Webpage on Cauliflower Ear/Auricular Hematoma

Tis the time of year when auricular hematoma is common with high school wrestling. Just in the past 3 weeks, our office had to treat 4 ear hematomas in order to prevent cauliflower ear formation. Given how common it is based on the season, a new webpage has been created describing this condition and how it can be treated.

Check it out here!