Document Detail

Tremor in otosurgery: influence of physical strain on hand steadiness.
MedLine Citation:
PMID:  11568677     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The microscopically small middle ear structures require the otosurgeon to have a steady hand because instrument stability is a critical factor for a successful microsurgical procedure. Hand steadiness is mainly influenced by the tremor movements of the hand. The aim of this study was to measure hand tremor under simulated microsurgical conditions and to estimate the influence of different kinds of physical strain (e.g., physical exertion and hand exercise), as well as food abstinence and coffee consumption. Further, the effect of one-or two-handed manipulation and microsurgical experience was investigated. METHODS: The hand movements of 16 adult subjects were assessed during a defined manual manipulation using a stapes model to simulate microsurgical procedures. A laserinterferometric-based displacement technique was developed to measure tremor amplitude and frequency, as well as maximum displacement, to evaluate the subjects' fine motor skills. RESULTS: The mean tremor frequency across all measurements was 8.1 Hz and did not show any dependence on different kinds of physical strain. Two-handed manipulations showed significantly lower tremor amplitudes than one-handed performances. Tremor amplitude and maximum displacement did not change after hand exercise, food abstinence, and coffee consumption. However, after physical exertion, a significant increase in the tremor amplitude was found. Subjects with advanced microsurgical experience showed smaller tremor amplitudes for one-handed runs. CONCLUSION: The tremor data are interpreted as a recommendation to avoid physical exertion before microsurgery. In cases of absolute necessity for hand steadiness, two-handed manipulations are preferable. Further, hand steadiness might be improved by microsurgical training and experience.
D Mürbe; K B Hüttenbrink; T Zahnert; U Vogel; M Tassabehji; E Kuhlisch; G Hofmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  22     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-24     Completed Date:  2001-12-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  672-7     Citation Subset:  IM    
Department of Otorhinolaryngology, Medical Faculty, Technical University, Dresden, Germany.
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MeSH Terms
Clinical Competence*
Ear, Middle / surgery*
General Surgery*
Hand / physiopathology*
Tremor / physiopathology*

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

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