Louis Armstrong’s Lip Problems: Satchmo’s Syndrome Reviewed

Rupture of the orbicularis muscle of the lips in wind musicians is known as Satchmo’s syndrome because it is assumed that Louis Armstrong (nicknamed Satchmo) suffered this condition. But whether Louis Armstrong really had this problem or not has never been documented. AIMS: This study is a biographical review and an analysis of the existing photographs of Armstrong’s lip with the aim of better understanding the origin and progression of his disorder. METHODS: A review was made of the most important biographies, newspapers, and magazines referring to Louis Armstrong and med¬ical reports about Satchmo’s syndrome. Major archives related to Louis Armstrong were searched for documents, photographs, articles, videos, letters, and other items, using the terms “lip,” “embouchure,” “mouth,” and “problem.” Information was sought on Armstrong’s playing technique, playing schedule, lip changes, lip problems, and other related health issues. RESULTS: It was found that Louis Armstrong suffered dermatological lip problems due to his intense playing schedule and the way he played from the very beginning of his career. This first created swelling and superficial erosions that later became cracks and fissures. These lesions finally produced ulcers which evolved into scar tissue after healing. This made the mucosa thicker and stiffer, making it more difficult for the lip to vibrate and forcing him to increase the tension and pressure in the area in order to play the trumpet. This created a vicious cycle with the scar tissue leading to further problems. These injuries even bled several times while he was playing and, on some occasions, left his mouth and clothes bloodied in the middle of concerts. His biography does not make any reference to difficulties or symptoms that could indicate that he had orbicularis oris muscle rupture, except for the fact that he had trouble playing, a symptom common to any injury to the lips in a wind instrument player. CONCLUSION: Analysis of the existing data indicates that Louis Armstrong’s lip problems were most likely due to mucosa fibromatous hyperplasia resulting from chronic microtrauma rather than a rupture of the orbicularis oris muscle. Therefore, we propose that this disorder should no longer be referred to as Satchmo’s syndrome.