# Massive Hypopharyngeal Dilatation and Cervical Lung Herniation in a Semi-Professional Wind Instrument Player: Highlighting the Necessity of Personalized Diagnostic and Management Strategies

## TL;DR

A wind instrument player developed rare throat and lung issues due to long-term high-pressure playing, showing the need for personalized medical strategies.

## Contribution

Highlights personalized diagnostic and management strategies for rare occupational conditions in wind instrument players.

## Key findings

- Dynamic imaging revealed hypopharyngeal expansion and cervical lung herniation during instrument playing.
- Multidisciplinary evaluation led to a personalized risk assessment and recommendation to stop playing.
- Literature review emphasizes individualized risk factors and treatment concepts for precision medicine.

## Abstract

Wind instrument performance requires sustained and repetitive increases in intrathoracic and pharyngeal pressures, which may lead to rare but clinically relevant anatomical alterations of the upper aerodigestive tract. We report the case of a 46-year-old male semi-professional wind instrument player who developed massive hypopharyngeal dilatation and cervical lung herniation as a consequence of long-term, high-pressure musical activity. Dynamic imaging performed during instrument playing demonstrated marked hypopharyngeal expansion and herniation of the lung apices into the cervical region, highlighting the importance of individualized diagnostic strategies that replicate patient-specific triggers. Multidisciplinary evaluation integrating otorhinolaryngology, thoracic surgery, radiology, and pulmonology led to a personalized risk assessment and the recommendation to cease wind instrument performance in order to prevent potentially life-threatening complications, such as pneumothorax. This case illustrates how personalized diagnostic approaches and tailored clinical decision-making are essential in managing rare occupational conditions. A comprehensive review of the literature is provided, with a focus on individualized risk factors, diagnostic strategies, and personalized treatment concepts relevant to precision medicine.