Ergonomics of Various Modalities for Ear Surgery

Area of Science:

• Otolaryngology
• Surgical Ergonomics
• Musculoskeletal Health

Background:

• Middle ear surgery poses ergonomic challenges for surgeons.
• Musculoskeletal disease (MSD) risk is a concern in surgical professions.
• Evaluating ergonomic differences across surgical modalities is crucial for surgeon well-being.

Purpose of the Study:

• To compare the ergonomic differences and associated MSD risk among various middle ear surgery modalities.
• To identify surgical techniques that minimize ergonomic strain and MSD risk.

Main Methods:

• An observational study analyzed intraoperative photographs of middle ear surgeries.
• The Rapid Upper Limb Assessment (RULA) tool was used to quantify MSD risk.
• Statistical analyses, including multivariable ordinal regression, compared ergonomic parameters and RULA scores across microscopic, endoscopic, and exoscopic surgery.

Main Results:

• Exoscopic surgery demonstrated significantly lower final RULA scores (indicating lower MSD risk) compared to endoscopic and microscopic surgery.
• Microscopic surgery showed worse wrist, trunk, and neck angles than endoscopic and exoscopic approaches.
• Multivariable analysis confirmed exoscopic surgery had significantly less ergonomic risk than microscopic surgery.

Conclusions:

• Exoscopic middle ear surgery presents the most favorable ergonomic profile among the studied modalities.
• While all modalities showed low ergonomic risk, exoscopic surgery offers the lowest MSD risk.
• Integrating exoscopic techniques with other ergonomic interventions can optimize musculoskeletal health for surgeons.