Work‐related musculoskeletal symptoms among otolaryngologists by subspecialty: A national survey

Ho, Thuy-Van Tina; Hamill, Chelsea S.; Sykes, Kevin J.; Kraft, Shannon

doi:10.1002/lary.26859

Cited by 49 publications

(81 citation statements)

References 10 publications

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“…First, this study had a small sample size and was from a single institution, which may limit its generalizability. However, we had an excellent response rate of 68.6%, which compares very favorably to the literature . Additionally, assessment of the REBA score can be subjective, as most postural positions are scored based on both an angular and a time factor.…”

Section: Discussionsupporting

confidence: 68%

“…A survey of American pediatric otolaryngologists reported that 62% of practitioners experience pain or discomfort attributed to their surgical practice, but only 31% of the practitioners were aware of ergonomics . Similar rates were reported by a large cohort of otolaryngologists from North America, which also found only a third of practitioners had knowledge of ergonomics …”

Section: Discussionmentioning

confidence: 64%

“…This suggests that ergonomics may not improve with experience and indicates that the problem starts early on in a surgical career and likely persists without intervention. Supporting this finding is a recent study, which found that the majority of the responders (63%) initially experienced MSK symptoms in their training years . Otolaryngology residents in the United States spend an average of 80 hours a week in the hospital, with 26 of those hours in the operating room .…”

Section: Discussionmentioning

confidence: 81%

“…Over the past century, several articles have tried to highlight the importance and the risk of OR ergonomics in otolaryngology. A 2016 survey of 377 otolaryngology surgeons in North America found that 63.9% reported work‐related MSK symptoms . A similar picture was seen among the 323 otolaryngology surgeons surveyed in the United Kingdom, with 47% reporting MSK disorders .…”

Section: Introductionmentioning

confidence: 77%

“…In our cohort, the standing position was significantly associated with cervical pain ( P = .034). Several other surveys of otolaryngology surgeons reported on neck pain as being most common MSK strain area during the surgery . Secondly, standing for extended periods of time (>30 minutes) almost always elevated the REBA risk score into the high‐risk category.…”

Section: Discussionmentioning

confidence: 93%

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Ergonomic hazards in otolaryngology

et al. 2018

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Objectives/Hypothesis To evaluate the presence of postural‐related strain and musculoskeletal discomfort, along with the level of ergonomics training and the availability of ergonomic equipment among otolaryngology surgeons. Study Design Intraoperative observations and survey study. Methods Using the Rapid Entire Body Assessment score system to identify ergonomic hazards, we conducted intraoperative observations assessing operating room personnel during different otolaryngological subspecialty procedures. Based on these findings, otolaryngology surgeons at a single academic institution in the United States were sent a survey that evaluated ergonomic practice, environmental infrastructure, and prior ergonomic training or education. Results A response rate of 69% was obtained from 70 surgeons, with 72.9% of responding surgeons suffering from some level of back pain, with cervical spine pain being the most common. Interestingly, residents were equally affected when compared to more senior surgeons both in subjective survey reports and from observational risk analysis. Furthermore, 43.8% of surgeons reported suffering from the highest level of pain when standing, whereas only 12.5% experienced pain when sitting. Importantly, 10% stated that pain impacted their work. Only 24% of surgeons had any prior ergonomic training or education. Conclusions Our data suggest that pain and disability induced by poor ergonomics are widespread among the otolaryngology community and confirm that surgeons rarely receive ergonomic training in the surgical context. Additionally, intraoperative observational findings identified that the majority of observed surgeons display poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazard. These data provide guidance for future interventional studies. Level of Evidence NA Laryngoscope, 129:370–376, 2019

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 93%

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Ergonomic hazards in otolaryngology

et al. 2018

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Estimation of surgeons’ ergonomic dynamics with a structured light system during endoscopic surgery

Lobo

Anuarbe

López‐Higuera

et al. 2019

Int Forum Allergy Rhinol

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Background:The purpose of this study was to use motion capture to collect body posture information during simulated endoscopic sinus surgery interventions performed by both specialists and residents in standing and si ing positions and to analyze that information with the validated Rapid Upper Limb Assessment (RULA) tool, which allows calculation of a risk index of musculoskeletal overload. Methods:Bilateral endoscopic sinus surgery was performed in 5 cadaver heads by 2 residents, and 4 practicing rhinologists. Musculoskeletal symptoms were evaluated before and a er the dissection. Full-body postural data were collected with the help of Kinect and a .NET WPF (Windows Presentation Foundation) so ware application to record images of the surgical procedures, and then analyzed with the RULA tool to calculate a risk score indicative of the exposure of the individual surgeon to ergonomic risk factors associated with upper extremity musculoskeletal disorders.Results: All subjects reported physical discomfort after nasal endoscopic procedures. An overall similar RULA score was obtained by the residents and the practicing rhinologists. The RULA score was slightly lower for the sitting position than for the standing position, mostly due to a lower score in group B (neck, trunk, and leg); however, the RULA score for group A (arm and wrist analysis) was higher, denoting a higher risk for the upper back and arms.Conclusion: Significant musculoskeletal symptoms were reported a er an endoscopic operation by both the resident and the practicing otolaryngologists. All surgeons obtained a high RULA score, meaning that urgent changes are required in the task. C 2019 ARS-AAOA, LLC. How to Cite this Article:Lobo D, Anuarbe P, López-Higuera JM, Viera J, Castillo N, Megía R. Estimation of surgeons' ergonomic dynamics with a structured light system during endoscopic surgery. Int Forum Allergy Rhinol. 2019;9:857-864.

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Surgeon Positioning During Awake Laryngeal Surgery: An Ergonomic Analysis

et al. 2021

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Objectives: While it is acknowledged that otolaryngologists performing microlaryngeal surgery can develop musculoskeletal symptoms due to suboptimal body positioning relative to the patient, flexible laryngoscopy and awake laryngeal surgeries (ALSs) can also pose ergonomic risk. This prospective study measured the effects of posture during ergonomically good and bad positions during laryngoscopy using ergonomic analysis, skin-surface electromyography (EMG), and self-reported pain ratings.Study Design: Prospective cohort study.Methods: Eight participants trained in laryngoscopy assumed four ergonomically distinct standing positions (side/near, side/far, front/near, front/far) at three different heights (neutral-top of patient's head in line with examiner's shoulder, high-6 inches above neutral, and low-6 inches below neutral) in relation to a simulated patient. Participants' postures were analyzed using the validated Rapid Upper Limb Assessment (RULA, 1 [best] to 7 [worst]) tool for the 12 positions. Participants then simulated ALS for 10 minutes in a bad position (low-side-far) and a good position (neutral-front-near) with 12 EMG sensors positioned on the limbs and torso.Results: The position with the worst RULA score was the side/near/high (7.0), and the best was the front/near/neutral (4.5). EMG measurements revealed significant differences between simulated surgery in the bad and good positions, with bad position eliciting an average of 206% greater EMG root-mean-squared magnitude across all sampled muscles compared to the good posture (paired t-test, df = 7, P < .01), consistent with self-reported fatigue/pain when positioned poorly.Conclusion: Quantitative and qualitative measurements demonstrate the impact of surgeon posture during simulated laryngoscopy and suggest ergonomically beneficial posture that should facilitate ALSs.

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Work‐related musculoskeletal symptoms among otolaryngologists by subspecialty: A national survey

Abstract: NA. Laryngoscope, 128:632-640, 2018.

Cited by 49 publications

References 10 publications

Ergonomic hazards in otolaryngology

Ergonomic hazards in otolaryngology

Estimation of surgeons’ ergonomic dynamics with a structured light system during endoscopic surgery

Surgeon Positioning During Awake Laryngeal Surgery: An Ergonomic Analysis

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