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Work-Related Musculoskeletal Disorders in Endoscopic Sinus and Skull Base Surgery: A Systematic Review With
Raewyn G Campbell1,2,3, Joshua R Zadro4, Andrew R Gamble1
1Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
Objective:
Endoscopic sinus and skull base surgery has led to significant improvements in patient outcomes, yet may have come at a cost to surgeons' musculoskeletal (MSK) health. We aimed to determine the prevalence and characteristics of work-related MSK disorders (WRMDs) in endoscopic sinus and skull base surgeons; to investigate contributing factors for WRMD in this population; and to evaluate the effectiveness of ergonomic interventions on the severity or prevalence of WRMD in this population.
Data Sources:
Medline, Embase, CINAHL, Web of Science, and Scopus from inception to April 2, 2024. A bibliographic examination was performed for further papers.
Review Methods:
Inclusion criteria included original peer-reviewed papers with work-related MSK outcomes (prevalence, contributing factors, and interventions) relating to endoscopic sinus and/or skull base surgeons in any language.
Results:
Of 25,772 unique citations, 37 studies met the inclusion criteria. The pooled lifetime, point, and 12-month prevalences of WRMD were 75.9% (95% confidence interval; I2, 67.2%-83.6%, I2 95.6%), 80.8% (77.0%-84.3%, I2 98.0%), and 82.0% (71.8%-90.3%, I2 60.96%) respectively. The neck, lumbar spine, and thoracic spine were the most commonly involved areas. One of 9 studies on contributing factors investigated discomfort as an outcome. The remainder focussed on surrogate outcomes (eg, posture, hand dysfunction). Two of the 13 intervention studies investigated pain or fatigue as an outcome. The remainder targeted posture, muscle activity, or workload.
Conclusion:
WRMDs are highly prevalent in endoscopic sinus and skull base surgeons. Further studies focusing on the direct outcomes of WRMD such as pain are needed.
Insights
Work-related musculoskeletal disorders (WRMDs) are highly prevalent in endoscopic sinus and skull base surgeons, affecting over 75% of practitioners. Further research is needed to explore pain and fatigue outcomes associated with these conditions.
Area of Science:
- Neurosurgery
- Otolaryngology
- Occupational Health
Background:
- Endoscopic sinus and skull base surgery offers improved patient outcomes.
- However, these procedures may pose risks to surgeons' musculoskeletal health.
Purpose of the Study:
- Determine the prevalence and characteristics of work-related musculoskeletal disorders (WRMDs) in endoscopic sinus and skull base surgeons.
- Investigate factors contributing to WRMDs in this surgical population.
- Evaluate the effectiveness of ergonomic interventions on WRMD severity or prevalence.
Main Methods:
- Comprehensive literature search across Medline, Embase, CINAHL, Web of Science, and Scopus.
- Inclusion of original peer-reviewed studies on work-related MSK outcomes in endoscopic sinus and/or skull base surgeons.
- Bibliographic examination for additional relevant papers.
Main Results:
- 37 studies from 25,772 citations met inclusion criteria.
- Pooled prevalences for WRMDs were 75.9% (lifetime), 80.8% (point), and 82.0% (12-month).
- The neck, lumbar, and thoracic spine were most commonly affected; intervention studies often focused on surrogate outcomes.
Conclusions:
- Work-related musculoskeletal disorders (WRMDs) are highly prevalent among endoscopic sinus and skull base surgeons.
- There is a need for further research focusing on direct WRMD outcomes like pain and fatigue.
