Document Detail


Ergonomic analysis of microlaryngoscopy.
MedLine Citation:
PMID:  19950376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Melissa McCarty Statham; Alison L Sukits; Mark S Redfern; Libby J Smith; John C Sok; Clark A Rosen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  120     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-02-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  297-305     Citation Subset:  IM    
Affiliation:
University of Pittsburgh Voice Center, Department of Otolaryngology, Pittsburgh, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Biomechanics
Body Height
Female
Human Engineering
Humans
Laryngoscopy*
Male
Microsurgery*
Musculoskeletal System / injuries,  physiopathology
Otolaryngology
Posture*
Surgical Equipment*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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