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