Surgeon Positioning During Awake Laryngeal Surgery: An Ergonomic Analysis.
Adult
Ergonomics
Female
Humans
Laryngoscopy
/ adverse effects
Male
Microsurgery
/ adverse effects
Middle Aged
Muscle Fatigue
/ physiology
Musculoskeletal Pain
/ epidemiology
Occupational Diseases
/ epidemiology
Prospective Studies
Self Report
/ statistics & numerical data
Standing Position
Surgeons
/ statistics & numerical data
Electromyography
awake laryngeal surgery
ergonomics
surgical ergonomics
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
06
05
2021
received:
29
03
2021
accepted:
05
06
2021
pubmed:
24
7
2021
medline:
25
11
2021
entrez:
23
7
2021
Statut:
ppublish
Résumé
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. Prospective cohort study. 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. 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. Quantitative and qualitative measurements demonstrate the impact of surgeon posture during simulated laryngoscopy and suggest ergonomically beneficial posture that should facilitate ALSs. 3 Laryngoscope, 131:2752-2758, 2021.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2752-2758Subventions
Organisme : Voice Health Institute(VHI), non-profit
ID : N/A
Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
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