Intraoperative Neck Angles in Endoscopic and Microscopic Otologic Surgeries.

Area of Science:

• Neurosurgery
• Orthopedics
• Surgical Technology

Background:

• Otologic surgeries traditionally use microscopes, but endoscopes are increasingly adopted.
• Both methods may present ergonomic challenges for surgeons.
• Quantifying and comparing these risks is crucial for surgeon well-being.

Purpose of the Study:

• To quantitatively compare the ergonomic risk associated with endoscopic versus microscopic otologic surgery.
• To assess intraoperative neck angles and identify high-risk postures.

Main Methods:

• An observational, cross-sectional study was conducted in an academic medical center.
• Inertial measurement unit sensors were used to track neck angles of surgeons during 17 otologic surgeries.
• Data were analyzed to calculate neck angles during active surgical periods.

Main Results:

• Both endoscopic and microscopic surgeries involved similar high percentages of time in risky neck positions (75% and 73%, respectively).
• Microscopic cases showed a significantly higher percentage of time in neck extension (25%) compared to endoscopic cases (12%).
• No significant difference was found in the magnitude of average flexion and extension angles between the two methods.

Conclusions:

• Both endoscopic and microscopic otologic surgery approaches are linked to high-risk neck angles, potentially causing sustained neck strain.
• Optimizing surgical ergonomics may depend more on applying fundamental ergonomic principles than solely on technological choices.