Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T04:55:45.880Z Has data issue: false hasContentIssue false
  • English
  • Français

A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons

Published online by Cambridge University Press:  29 September 2021

B Storey Open the ORCID record for B Storey [Opens in a new window] ,
M Verkerk ,
A Hashtroudi  and
D Golding-Wood
B Storey*
Affiliation:
King's College Hospital NHS Foundation Trust, London, UK
M Verkerk
Affiliation:
Guy's and St Thomas’ NHS Foundation Trust, London, UK
A Hashtroudi
Affiliation:
Guy's and St Thomas’ NHS Foundation Trust, London, UK
D Golding-Wood
Affiliation:
King's College Hospital NHS Foundation Trust, London, UK
*
Author for correspondence: Mr B Storey, King's College Hospital, Denmark Hill, LondonSE5 9RS, UK E-mail: bradleystorey@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Work-related musculoskeletal disorders in ENT surgeons are common and detrimental, yet few are aware of preventative measures. We evaluate the evidence for interventions to prevent work-related musculoskeletal disorders in ENT surgeons.

Method

A systematic search of databases up to 8 June 2021 was performed using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and predetermined inclusion criteria.

Results

Seven prospective cohort studies and 2 case series were identified (51 participants). Interventions included novel equipment (n = 3), patient positioning (n = 2), clinician positioning (n = 3) and operative technique (n = 1). Five studies reported Rapid Upper Limb Assessment scores as outcome measures of strain. Strain decreased when adopting a favourable operating posture, using a supportive chair and keeping patients supine for clinic procedures.

Conclusion

A small number of low-quality studies were identified. Modifiable risk factors exist, and ergonomic education may help prevent work-related musculoskeletal disorders. Further studies with longer term follow up are required.

Keywords

Musculoskeletal DiseasesPostureOccupational TherapyErgonomicsPatient PositioningSurgeonsRisk Factors
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 7 , July 2022 , pp. 622 - 627
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr B Storey takes responsibility for the integrity of the content of the paper

Presented at the Association of Surgeons in Training 2020 Conference, 6–8 March 2020, Birmingham, UK and Virtual British Academic Conference in Otolaryngology International, 10–12 January 2021, online.

References

Babar-Craig, H, Banfield, G, Knight, J. Prevalence of back and neck pain amongst ENT consultants: national survey. J Laryngol Otol 2003;117:979–82CrossRefGoogle ScholarPubMed
Bolduc, J, François, B, Apostolos, P, Tareck, C. Work-related musculoskeletal symptoms amongst otolaryngologists and head and neck surgeons in Canada. Eur Arch Otorhinolaryngology 2018;275:261–7CrossRefGoogle Scholar
Dabholkar, T, Yardi, S, Dabholkar, YG, Velankar, HK. A Survey of work-related musculoskeletal disorders among otolaryngologists. Indian J Otolaryngol Head Neck Surg 2017;69:230–8CrossRefGoogle ScholarPubMed
Vijendren, A, Yung, M, Sanchez, J, Duffield, K. Occupational musculoskeletal pain amongst ENT surgeons – are we looking at the tip of an iceberg? J Laryngol Otol 2016;130:490–6CrossRefGoogle ScholarPubMed
Wong, K, Grundfast, KM, Levi, JR. American Journal of Otolaryngology – Head and Neck Medicine and Surgery assessing work-related musculoskeletal symptoms among otolaryngology residents. Am J Otolaryngol Neck Med Surg 2017;38:213–7Google ScholarPubMed
Lobo, D, Gandarillas, MA, Sánchez-Gómez, S, Megía, R. Work-related musculoskeletal symptoms in otorhinolaryngology and their relationship with physical activity. A nationwide survey. J Laryngol Otol 2019;133:713–8CrossRefGoogle ScholarPubMed
Boyle, S, Fitzgerald, C, Conlon, BJ, Vijendren, A. A national survey of workplace-related musculoskeletal disorder and ergonomic practices amongst Irish otolaryngologists. Ir J Med Sci. Epub 2021 May 8Google Scholar
Schneider, E, Irastorza, X, Copsey, S. OSH in Figures: Work-Related Musculoskeletal Disorders in the EU – Facts and Figures. Luxembourg: European Agency for Safety and Health at Work, 2010Google Scholar
Kaup, S, Shivalli, S, Kulkarni, U, Arunachalam, C. Ergonomic practices and musculoskeletal disorders among ophthalmologists in India: an online appraisal. Eur J Ophthalmol 2018;30:196–200CrossRefGoogle ScholarPubMed
Davila, VJ, Meltzer, AJ, Hallbeck, MS, Stone, WM. Physical discomfort, professional satisfaction, and burnout in vascular surgeons. J Vasc Surg 2019;70:913–20CrossRefGoogle ScholarPubMed
Epstein, S, Tran, BN, Capone, AC, Lee, BT, Singhal, FD. Work-related musculoskeletal disorders among plastic surgeons: a systematic review. J Reconstr Microsurg 2017;34:553–62CrossRefGoogle ScholarPubMed
Sharan, D, Rajkumar, JS, Balakrishnan, R. Work related musculoskeletal disorders among orthopaedic surgeons: a survey study. Occup Environ Med 2018;75:A642Google Scholar
Janki, S, Mulder, EEAP, Ijzermans, JNM, Tran, TCK. Ergonomics in the operating room. Surg Endosc 2017;31:2457–66CrossRefGoogle ScholarPubMed
Glickson, J. Surgeons experience more ergonomic stress in the OR. Bull Am Coll Surg. In: https://bulletin.facs.org/2012/04/surgeons-experience-more-ergonomic-stress-in-the-or/ 2012 [18 July 2019]Google Scholar
Marciano, F, Mattogno, PP, Codenotti, A, Cocca, P, Fontanella, MM, Doglietto, F. Work-related musculoskeletal disorders among endoscopic transsphenoidal surgeons: a systematic review of prevalence and ergonomic interventions. Int J Occup Saf Ergon 2020;28:459–68CrossRefGoogle ScholarPubMed
Health and Safety Executive. Upper limb disorders. In: https://www.hse.gov.uk/msd/uld/index.htm [25 March 2021]Google Scholar
Rimmer, J, Amin, M, Fokkens, WJ, Lund, VJ. Endoscopic sinus surgery and musculoskeletal symptoms. Rhinology 2016;54:105–10CrossRefGoogle ScholarPubMed
Wong, A, Baker, N, Smith, L, Rosen, CA. Prevalence and risk factors for musculoskeletal problems associated with microlaryngeal surgery: a national survey. Laryngoscope 2014;124:1854–61CrossRefGoogle ScholarPubMed
Catanzarite, T, Tan-Kim, J, Whitcomb, EL, Menefee, S. Ergonomics in Surgery. Female Pelvic Med Reconstr Surg 2017;24:1CrossRefGoogle Scholar
Nimbarte, A, Sivak-Callcott, J, Zreiqat, M, Chapman, M. Neck postures and cervical spine loading among microsurgeons operating with loupes and headlamp. IIE Trans Occup Ergon Hum Factors 2013;1:215–23CrossRefGoogle Scholar
Howarth, A, Hallbeck, S, Mahabir, R, Lemaine, V, Evans, G, Noland, S. Work-related musculoskeletal discomfort and injury in microsurgeons. J Reconstr Microsurg 2019;35:322–8Google ScholarPubMed
Ayad, T, Péloquin, L, Prince, F. Ergonomics in endoscopic sinus surgery: systematic review of the literature. J Otolaryngol 2005;34:333–40CrossRefGoogle ScholarPubMed
Rodman, C, Kelly, N, Niermeyer, W, Banks, L, Onwuka, A, Mason, E et al. Quantitative assessment of surgical ergonomics in otolaryngology. Otolaryngol Neck Surg 2020;163:1186–93CrossRefGoogle ScholarPubMed
Maxner, A, Gray, H, Vijendren, A. A systematic review of biomechanical risk factors for the development of work-related musculoskeletal disorders in surgeons of the head and neck. Work 2021;69:247–63CrossRefGoogle ScholarPubMed
Hoe, V, Urquhart, D, Kelsall, H, Sim, M. Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults. Cochrane Database Syst Rev 2012;(8):CD008570Google Scholar
Soueid, A, Oudit, D, Thiagarajah, S, Laitung, G. The pain of surgery: pain experienced by surgeons while operating. Int J Surg 2010;8:118–20CrossRefGoogle ScholarPubMed
Ho, TT, Hamill, CS, Sykes, KJ, Kraft, SM. Work-related musculoskeletal symptoms among otolaryngologists by subspecialty: a national survey. Laryngoscope 2018;128:632–40CrossRefGoogle ScholarPubMed
Cavanagh, J, Brake, M, Kearns, D, Hong, P. Work environment discomfort and injury: an ergonomic survey study of the American Society of Pediatric Otolaryngology members. Am J Otolaryngol Neck Med Surg 2012;33:441–6Google ScholarPubMed
Vaisbuch, Y, Aaron, KA, Moore, JM, Vaughan, J, Ma, Y, Gupta, R et al. Ergonomic hazards in otolaryngology. Laryngoscope 2019;129:370–6CrossRefGoogle ScholarPubMed
OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2. In: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence [24 June 2019]Google Scholar
Sterne, JA, Hernán, MA, Reeves, BC, Savović, J, Berkman, ND, Viswanathan, M et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016;355Google ScholarPubMed
Vijendren, A, Devereux, G, Kenway, B, Duffield, K, Van Rompaey, V, van de Heyning, P et al. Effects of prolonged microscopic work on neck and back strain amongst male ENT clinicians and the benefits of a prototype postural support chair. Int J Occup Saf Ergon 2017;25:402–411CrossRefGoogle ScholarPubMed
Statham, MMC, Sukits, AL, Redfern, MS, Smith, LJ, Sok, JC, Rosen, CA. Ergonomic analysis of microlaryngoscopy. Laryngoscope 2010;120:297–305CrossRefGoogle ScholarPubMed
Chen, T, Dailey, SH, Naze, SA, Jiang, JJ. The head-mounted microscope: a potential precision improvement in phonomicrosurgery. Laryngoscope 2012;122:781–4CrossRefGoogle Scholar
Govil, N, Demayo, WM, Hirsch, BE, McCall, AA. Optimizing positioning for in-office otology procedures. Otolaryngol – Head Neck Surg (United States) 2017;156:156–60CrossRefGoogle ScholarPubMed
Govil, N, DeMayo, WM, Hirsch, BE, McCall, AA. Patient positioning during in-office otologic procedures impacts physician ergonomics. Otol Neurotol 2018;39:e883–8CrossRefGoogle ScholarPubMed
Smith, LJ, Trout, JM, Sridharan, SS, Guyer, JR, Owens, GE, Chambers, AJ et al. Comparison of microsuspension laryngoscopy positions: a randomized, prospective study. Laryngoscope 2015;125:649–54CrossRefGoogle ScholarPubMed
Ramakrishnan, VR, Milam, BM. Ergonomic analysis of the surgical position in functional endoscopic sinus surgery. Int Forum Allergy Rhinol 2017;7:570–5CrossRefGoogle ScholarPubMed
Lobo, D, Anuarbe, P, López-Higuera, JM, Viera, J, Castillo, N, Megía, R. Estimation of surgeons’ ergonomic dynamics with a structured light system during endoscopic surgery. Int Forum Allergy Rhinol 2019;9:857–64CrossRefGoogle ScholarPubMed
Lee, J, Kang, SW, Jung, JJ, Choi, UJ, Yun, JH, Nam, KH et al. Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations. Ann Surg Oncol 2011;18:2538–47CrossRefGoogle ScholarPubMed
Mcatamney, L, Corlett, EN. RULA: a survey method for the investigation of work-related upper limb disorders. Appl Ergon 1993;24:91–9CrossRefGoogle ScholarPubMed
Park, H-S, Kim, J, Roh, H-L, Namkoong, S. Analysis of the risk factors of musculoskeletal disease among dentists induced by work posture. J Phys Ther Sci 2015;27:3651–3654CrossRefGoogle ScholarPubMed
Dabholkar, TY, Yardi, SS, Oak, SN, Ramchandani, S. Objective ergonomic risk assessment of wrist and spine with motion analysis technique during simulated laparoscopic cholecystectomy in experienced and novice surgeons. J Minim Access Surg 2017;13:124–30Google ScholarPubMed
Wijsman, PJM, Molenaar, L, Van, CDP, Bas, H, Wim, STVV. Ergonomics in handheld and robot-assisted camera control: a randomized controlled trial. Surg Endosc 2019;33:3919–25CrossRefGoogle ScholarPubMed
Li, Z, Baber, C, Macdonald, C, Godwin, Y. Predicting upper limb discomfort for plastic surgeons: combining anthropometric models with rapid upper limb assessment (RULA). Cogent Eng 2017;4:1–15Google Scholar
Giagio, S, Volpe, ÃG, Pillastrini, ÃP, Gasparre, G, Frizziero, A, Squizzato, F. A preventive program for work-related musculoskeletal disorders among surgeons: outcomes of a randomized controlled clinical trial. Ann Surg 2019;270:969–75CrossRefGoogle ScholarPubMed
Rosenblatt, PL, McKinney, J, Adams, SR. Ergonomics in the operating room: protecting the surgeon. J Minim Invasive Gynecol 2013;20:744CrossRefGoogle ScholarPubMed
Reddy, PP, Reddy, TP, Roig-francoli, J, Cone, L, Sivan, B, Defoor, WR et al. The impact of the alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study. J Urol 2011;186:1658–62CrossRefGoogle ScholarPubMed
Hoe, V, Urquhart, D, Kelsall, H, Zamri, E, Sim, M. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers (Review). Cochrane Database Syst Rev 2018;(10):CD008570Google Scholar