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Surgeon Positioning During Awake Laryngeal Surgery: An Ergonomic Analysis
Brandon J Baird1,2, Monica A Tynan1, Lauren F Tracy1,3
1Department of Surgery, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
The Laryngoscope
|July 23, 2021
Summary
Surgeon posture significantly impacts ergonomic risk during laryngoscopy. Optimizing body positioning can reduce musculoskeletal strain and improve safety for awake laryngeal surgeries (ALSs).
Area of Science:
- Otolaryngology
- Ergonomics
- Musculoskeletal Health
Background:
- Otolaryngologists performing microlaryngeal surgery risk musculoskeletal symptoms from poor posture.
- Flexible laryngoscopy and awake laryngeal surgeries (ALSs) also present ergonomic challenges.
- Understanding posture's impact is crucial for surgeon well-being and patient safety.
Purpose of the Study:
- To quantitatively assess the ergonomic risks associated with different surgeon postures during laryngoscopy.
- To compare muscle activity and self-reported pain between ergonomically good and bad positions.
- To identify optimal body positioning for performing awake laryngeal surgeries (ALSs).
Main Methods:
- Prospective study involving eight participants simulating laryngoscopy in 12 distinct positions.
- Ergonomic analysis using the Rapid Upper Limb Assessment (RULA) tool.
- Skin-surface electromyography (EMG) to measure muscle activity during simulated ALS in good and bad postures.
Main Results:
- The worst RULA score (7.0) was observed in the side/near/high position; the best (4.5) was in the front/near/neutral position.
- Simulated surgery in a bad posture resulted in 206% greater EMG activity compared to a good posture.
- Increased muscle activity in poor positions correlated with higher self-reported fatigue and pain.
Conclusions:
- Surgeon posture during laryngoscopy has a significant impact on ergonomic risk.
- Quantitative and qualitative data support the identification of ergonomically beneficial postures.
- Adopting recommended postures can help mitigate musculoskeletal strain during awake laryngeal surgeries (ALSs).
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