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I just did a few experiments, and I think I've ruled out the large chamber theory. I used a large chamber tenor mouthpiece on an alto, which should have a larger chamber than any alto mouthpiece. It played all the palm notes fine with no effort. Then I went as high as I could in the altissimo and made it up to Eb4 (couldn't quite get to zxcvbnm's F4), no problems. Then I tried without to octave key to duplicate an octave pip blockage. I could still play the palm notes, but it definitely took an effort to keep them from dropping. Altissimo wasn't much more of a problem without the octave key. So a blocked pip isn't as much of an issue with altissimo, explaining why the palm keys had issues but the altissimo didn't.

So I think a blocked pip is the most likely culprit. But I can say from experience that certain synthetic reeds try to drop the octave on the palm notes as well. I don't remember if the OP mentioned playing synthetics, but that could also be the culprit. I definitely have that problem with Legere. Even though zxcvbnm has exceptional altissimo skills, that doesn't necessarily rule out a technique issue on the palm notes.
 

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Definitely check for leaks, but if you can’t play high F, all the palm keys are open so couldn’t possibly be a palm key leak. In my experience palm key leaks cause greater resistance in lower notes, not problems with high notes.
 

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Interesting. I don't think the upper octave pip is blocked but I can check. Maybe in the worst case it needs to be bored out to a larger diameter?
I think you have to be very careful with the diameter. I wouldn't do anything drastic.

Is the synthetic reed issue a possibility?
 
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