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Ergonomic analysis of microlaryngoscopy.
Laryngoscope. 2010 Feb; 120(2):297-305.L

Abstract

OBJECTIVES/HYPOTHESIS

To apply ergonomic principles in analysis of three different operative positions used in laryngeal microsurgery.

STUDY DESIGN

Prospective case-control study.

METHODS

Laryngologists were studied in three different microlaryngeal operative positions: a supported position in a chair with articulated arm supports, a supported position with arms resting on a Mayo stand, and a position with arms unsupported. Operative positions were uniformly photographed in three dimensions. Full body postural data was collected and analyzed using the validated Rapid Upper Limb Assessment (RULA) tool to calculate a risk score indicative of potential musculoskeletal misuse in each position. Joint forces were calculated for the neck and shoulder, and compression forces were calculated for the L5/S1 disc space.

RESULTS

Higher-risk postures were obtained with unfavorably adjusted eyepieces and lack of any arm support during microlaryngeal surgery. Support with a Mayo stand led to more neck flexion and strain. Using a chair with articulated arm supports leads to decreased neck strain, less shoulder torque, and decreased compressive forces on the L5/S1 disc space. Ideal postures during microlaryngoscopy place the surgeon with arms and feet supported, with shoulders in an unraised, neutral anatomic position, upper arms neutrally positioned 20 degrees to 45 degrees from torso, lower arms neutrally positioned 60 degrees to 100 degrees from torso, and wrists extended or flexed <15 degrees.

CONCLUSIONS

RULA and biomechanical analyses have identified lower-risk surgeon positioning to be utilized during microlaryngeal surgery. Avoiding the identified high-risk operative postures and repetitive stress injury may lead to reduced occupationally related musculoskeletal pain and may improve microsurgical motor control.

Authors+Show Affiliations

University of Pittsburgh Voice Center, Department of Otolaryngology, Pittsburgh, Pennsylvania, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19950376

Citation

Statham, Melissa McCarty, et al. "Ergonomic Analysis of Microlaryngoscopy." The Laryngoscope, vol. 120, no. 2, 2010, pp. 297-305.
Statham MM, Sukits AL, Redfern MS, et al. Ergonomic analysis of microlaryngoscopy. Laryngoscope. 2010;120(2):297-305.
Statham, M. M., Sukits, A. L., Redfern, M. S., Smith, L. J., Sok, J. C., & Rosen, C. A. (2010). Ergonomic analysis of microlaryngoscopy. The Laryngoscope, 120(2), 297-305. https://doi.org/10.1002/lary.20686
Statham MM, et al. Ergonomic Analysis of Microlaryngoscopy. Laryngoscope. 2010;120(2):297-305. PubMed PMID: 19950376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ergonomic analysis of microlaryngoscopy. AU - Statham,Melissa McCarty, AU - Sukits,Alison L, AU - Redfern,Mark S, AU - Smith,Libby J, AU - Sok,John C, AU - Rosen,Clark A, PY - 2009/12/2/entrez PY - 2009/12/2/pubmed PY - 2010/2/17/medline SP - 297 EP - 305 JF - The Laryngoscope JO - Laryngoscope VL - 120 IS - 2 N2 - OBJECTIVES/HYPOTHESIS: To apply ergonomic principles in analysis of three different operative positions used in laryngeal microsurgery. STUDY DESIGN: Prospective case-control study. METHODS: Laryngologists were studied in three different microlaryngeal operative positions: a supported position in a chair with articulated arm supports, a supported position with arms resting on a Mayo stand, and a position with arms unsupported. Operative positions were uniformly photographed in three dimensions. Full body postural data was collected and analyzed using the validated Rapid Upper Limb Assessment (RULA) tool to calculate a risk score indicative of potential musculoskeletal misuse in each position. Joint forces were calculated for the neck and shoulder, and compression forces were calculated for the L5/S1 disc space. RESULTS: Higher-risk postures were obtained with unfavorably adjusted eyepieces and lack of any arm support during microlaryngeal surgery. Support with a Mayo stand led to more neck flexion and strain. Using a chair with articulated arm supports leads to decreased neck strain, less shoulder torque, and decreased compressive forces on the L5/S1 disc space. Ideal postures during microlaryngoscopy place the surgeon with arms and feet supported, with shoulders in an unraised, neutral anatomic position, upper arms neutrally positioned 20 degrees to 45 degrees from torso, lower arms neutrally positioned 60 degrees to 100 degrees from torso, and wrists extended or flexed <15 degrees. CONCLUSIONS: RULA and biomechanical analyses have identified lower-risk surgeon positioning to be utilized during microlaryngeal surgery. Avoiding the identified high-risk operative postures and repetitive stress injury may lead to reduced occupationally related musculoskeletal pain and may improve microsurgical motor control. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/19950376/Ergonomic_analysis_of_microlaryngoscopy_ L2 - https://doi.org/10.1002/lary.20686 DB - PRIME DP - Unbound Medicine ER -