(465) Surgical Ergonomics in Otolaryngology: The Past, Present, and Future

Introduction: The primary objective of this pilot project is to examine the body postures of Otolaryngologists leading to the development of cervical-spinal work-related musculoskeletal disorders (WRMDs) and how ergonomic education, training and biofeedback devices may reduce WRMDs thereby improving career longevity through operant conditioning. Secondarily, we will explore the potential for biofeedback to distract the user and affect residential training or surgical outcomes.

Methods: The 3-month study consisted of various otolaryngology surgeries conducted at three military medical centers with nine military operators- one medical student, eight residents, and one attending. Participants performed cases wearing a commercially designed vibratory biofeedback device, the UpRight GO (UG2). The UG2 was held in place on C7 with adhesives provided with the device. The digital application designed by UPRIGHT was used to trend the users’ cervical spine Upright Time percentages (UTPs) secondary to corrective biofeedback throughout the procedures.

Results: An attending, two PGY5s, and one PGY1- performed Microscopic Tympanostomies with UTPs of 92% for 22 minutes, 87% for 48 minutes, 71% for 31 minutes*, and 77% for 54 minutes, respectively. Two residents- PGY5 and PGY2, performed bilateral tonsillectomies with a large difference in UTPs of 78% to 24% for 40 minutes, respectively.

Conclusions: Recent ergonomic publications in Otolaryngology have linked prolonged poor body positions, wearing of loops, and headlamps to the development of Work-Related Musculoskeletal Disorders (WRMDs). Over time, these WRMDs can reduce the number of cases performed or, worse, retirement. As with the development of any aliment, the best defense is prevention. The trend of higher Upright Time Percentage for those with more experience is suggestive that the inciting pathophysiology of WRMDs most likely begins in the surgeons' earlier training years. Further study is needed to assess if earlier ergonomic education, training, and interventions will reduce the development WRMDs and prolong the careers of current and budding Otolaryngologists.